Epilepsy is a chronic condition of the brain that can cause recurring seizures. Approximately 70 million people worldwide have an epilepsy diagnosis. Epilepsy is the third most common neurological disorder in people over the age of 65, after stroke and dementia (Cavalcante, August 2021). People with epilepsy are typically less active compared to the rest of the population. This is widely due to the stigma and fear of inducing seizures or increasing seizure frequency. Therefore, people diagnosed with epilepsy are typically discouraged from participating in regular physical activity or sport (Arida, 2008). In this blog, we will be diving into the benefits of participating in regular exercise and sport for people with epilepsy, as well as some safety aspects to be aware of.
Risk vs. Reward of Participating in Sport and Exercise
Although epilepsy is characterized by recurrent, unprovoked seizures, they can be brought on or triggered by a number of factors. Some common factors that can increase the risk of a seizure include:
- Sleep deprivation
- Stress
- Infectious diseases
- Menstrual cycle
- Alcohol consumption
- Prolonged fasting
- Physical exhaustion
- Photic stimulation (flashing or flickering light)
Whether or not physical activity is a trigger for inducing seizures has not been fully clarified and has received little attention in research. However, some of the possible reported factors related to exercise are hyperthermia, hypoglycaemia, hyponatremia, hypoxia, hyperventilation, fatigue, and stress of competition (Arida R. M., 2021).
There are some rare cases of exercise-induced seizures, however, studies have shown that physical activity can actually decrease the frequency of seizures. Physical activity has also been proven to increase cardiovascular and psychological health in people with epilepsy. Most physical activities or sports are safe for people with epilepsy to participate in. However, special consideration should be taken to ensure adequate seizure control, close monitoring of medications, and notifying coaches or trainers. The evidence has shown that patients with good seizure control can participate in both non-contact and contact sports without negatively affecting seizure frequency (Arida R. M., 2008).
Epilepsy Pathophysiology and Physical Activity
Research has found that physical inactivity can contribute to worse epilepsy pathophysiology – the physiological process associated with a condition (Cavalcante, August 2021).
Implementing regular physical exercise has been proven to be beneficial for individuals with epilepsy by decreasing the production of pro-inflammatory and stress biomarkers, as well as increasing social connection, and reducing the frequency of seizures. Physical activity and exercise are also capable of reducing symptoms of depression and anxiety for people with epilepsy. An improvement in cognitive function has also been linked to participating in regular activity for people diagnosed with epilepsy. This particular study found that “regular practice of physical exercise enhances the levels of brain-derived neuro factor (BDNF) in the hippocampi, induces neurogenesis, inhibits oxidative stress and reactive gliosis, avoids cognitive impairment, and stimulates the production of dopamine in the epileptic brain” (Cavalcante, August 2021).
The evidence from experimental studies on seizure frequency and exercise indicate multiple mechanisms to moderate the inhibitory and excitatory balance to reduce seizure susceptibility, including modulation of neurotransmitters, neurotrophins and brain metabolism (Arida R. M., 2021). The clinical studies that implement an exercise program of moderate intensity demonstrate a positive impact on seizure frequency which is associated with an improved quality of life for people with epilepsy. Further studies implementing high/vigorous intensity exercise have reported a reduction of epileptiform discharges during and after exercise, suggesting that physical activity is not a seizure-inducing factor (Arida R. M., 2021).
Therefore, physical activity and exercise are excellent non-pharmacological adjunctive forms of treatment for epilepsy. Implementing regular exercise or physical activity of any mode (running, swimming, bike riding, sport, gym, dance, etc.) provides positive physical and psychological changes in people diagnosed with epilepsy.
Written by Uplift Exercise Physiologist, Molly Cushan
References
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Arida, R. M. (2008). Physical activity and epilepsy: proven and predicted benefits . Sports medicine (Auckland, N.Z.).
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Arida, R. M. (2021). Physical exercise and seizure activity. BBA – Molecular Basis of Disease .
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Cavalcante, B. R. (August 2021). Exercise-linked consequences on epilepsy. Epilepsy & Behavior, Volume 121, Part A
