Abstracts

RATIONALE: Patients with epilepsy (PWE) are restricted in many aspects of their lives. PWE are often denied participation in exercise and sporting activities due to concerns of a theoretical risk of seizure exacerbation during such physical activity. Partaking in sporting activities and exercise may improve quality of life for patients with epilepsy. Additionally, exercise is commonly used in epilepsy monitoring units (EMU) to exacerbate seizures. However, little information exists regarding the relationship of seizures to exercise. This study will allow the participant to understand how mild aerobic exercise impacts seizure exacerbation in patients with partial onset seizures.
METHODS: Detailed time records of 25 confirmed partial seizure patients (ES) and 25 non-epileptic seizure patients (NES) who were admitted to the Mayo Clinic Arizona[ssquote]s EMU were analyzed. Patients were admitted for diagnostic or pre-surgical evaluation. All patients who were physically able to exercise, rode a stationary bike under supervision on a daily basis for 10 minute sessions. All seizure patients included in this study had their anti-seizure drugs discontinued after a brief taper. Events were recorded during continuous video EEG and their temporal relation to the exercise sessions were noted in all patients. The number of events occuring within 2 and 6 hours the exercise session were evaluated. The number of exercise sessions, total events and the mean time to first event after each session were noted in each group were noted. Chi-square analysis was utilized in comparing the number of events at 2 and 6 hours.
RESULTS: The NES group had a total of 122 events occuring after a total of 138 exercise sessions. Measuring the time to first event revealed that that within this group 7 and 13 events occured within 2 and 6 hours respectivly. The mean time to onset of the first event was 28.5 min and 118.5 minutes respectively.
The epilepsy group was noted to have 172 exercise sessions and 100 total events. Eight and 12 seizures occurred within 2 and 6 hours respectively. The mean time to first event in this group was 26.5 and 105 minutes respectively. These mean times to the first event were not sigificantly different compared between ES and NES groups. (p=0.86; p=0.72 for 2 and 6 hours resp.)
Chi-square analysis between the NES and seizure group for the number of events number of events within the 2 and 6 hour post exercise time frame showed no significant difference in the proportion of those that had events. (P=0.75 and 0.77 resp).
CONCLUSIONS: There is no difference between ES and NES patients regarding the number of events occuring shortly after mild aerobic exercise. The results suggest that mild exercise may be performed safely by some patients with partial epilepsy without exacerbating seizures. These data have implications for deciding whether to exercise patients in EMUs to provoke seizures. Further prospective studies are needed to clearly define the relationship between exercise and seizures so that PWE may be counseled appropriately to ensure patient safety and potentially allow for participation in more vigorous physical activity.