Abstracts

Rationale: Loss of consciousness during seizures is a factor which limits activity of patients with epilepsy. Driving restrictions is reported to have the most impact on quality of life and gained most attention. Testing individuals in the ictal state to determine ability to perform these activities has logisitcal difficulties. Bicycling is another activity of concern that the impact of seizures is unclear. We observed two patients who continued to use a stationary bicycle during part of VEEG recorded seizures. Methods: Two patients with intractable seizures admitted for VEEG evaluation. Several seizures were recorded in both patients and each had one while using stationary bicycle. Results: Patient 1 was a 43 year old male with a long history of intractable complex partial seizures. While using a stationary exercise bicycle, the patient continue to cycle for 30 seconds despite instructions to stop with simultaneous left temporal seizure activity. The second Patient 2 was a 25 year old male with frontal lobe epilepsy and generalized tonic-clonic seizures. This patient continued to pedal on the bicycle during 30 seconds of ictal generalized epileptiform pattern prior to tonic-clonic seizure. Conclusions: Pedalling of stationary bicycle occurred during VEEG confirmed seizure activity thought to arise from temporal lobe in one and frontal lobe in the other patient. Loss of awareness was confirmed in one patient with lateralized seizure activity, and in the other generalized discharge was present. Although using a stationary bicycle may not require the same level of consciousness as cycling, these movements did persist during EEG seizure activity. This suggests that brief seizures during cycling may not result in adverse events related to loss of awareness and is worthy of further study.