# Exercise as it relates to Disease/The Effects of Exercise on Epilepsy
## What is epilepsy?

Epilepsy is a neurological disorder which involves the brain’s susceptibility to recurring epileptic seizures. Repeated seizures are caused by an abnormal amount of neuronal activity (imbalance between excitation and inhibition) in the brain. There are more than 40 types of seizures that can be categorised into two main groups; partial and generalised. Partial seizures last a few seconds and in simple cases, the individual will remain completely conscious. Generalised seizures can occur many times a day with each episode lasting for 10 seconds or less. The whole brain is affected and there is an impairment of consciousness.

## Diagnosis of Epilepsy

A diagnosis should be made urgently (recommended within 2 weeks) by a neurologist by assessing the patients history and account of the seizure(s). Clinical diagnosis is based on the criteria from the International League Against Epilepsy (ILAE), this is taken in junction with an electroencephalogram (EEG) and/or a magnetic resonance imaging (MRI) scan. Symptoms of epilepsy include loss of consciousness, collapse, excessive salivation and convulsive movements (also connected with tongue biting and urinary incontinence).

## Triggers for epilepsy

* Lack of sleep
* Menstruation
* Excessive intake of alcohol
* Illness
* Stress
* Illicit drugs
* Photosensitivity
* Missing medication

## Causes of epilepsy

* Congenital and genetic disorders
* Acquired: trauma, infection, neurosurgery
* Metabolic disorders: stroke, toxic disorders (alcohol and drugs), demyelination disease (multiple sclerosis).

## Treatment

Antiepilepsy drugs (AEDs) are the fundamental treatment of epilepsy. They are usually a lifelong therapy and work by decreasing the irritability of neurons. Determining which AED to use is based on the seizure type, age, health status, lifestyle, employment and side effects. There are more than 20 antiepileptic drugs that are licensed worldwide, with the aim to suppress the symptom of seizures.

### Non-pharmacological treatment

Most people take antiepileptic medication to control seizures, but some use alternative therapies as a complementary therapy.

### Examples of non-pharmacological treatment

* Ketogenic diet
* Acupuncture
* Massage
* Aerobic exercise
* Music therapy
* Yoga
* Garlic
* Magnetic therapy

### Surgery

Some types of epilepsies may be eradicated through surgery; a doctor will determine whether the patient is suitable for surgery.

## Exercise and epilepsy

It has been observed that epileptics generally have a lack of physical fitness and experience poor general health and overall quality of life. Many patients with epilepsy present insufficient aerobic fitness, muscular strength and flexibility. A factor accountable for this may be the concern with physical activity and epileptic patients. For so long people with epilepsy were often told to steer clear of vigorous exercise, although there are some cases of exercise-induced seizures, there is supportive evidence that shows physical activity to be beneficial for persons with epilepsy. Studies show that exercise can decrease the frequency of seizures in people with epilepsy. It is suggested that with an increase in both mental and physical activity there is a reduction in the incidence of seizures and improvement of mental health.

### Effects of exercise on epilepsy

People with epilepsy are often people who suffer from depression and anxiety disorders. Similarly to the general population, epileptics show an improved mood with regular exercise. Studies have showed that people who have epilepsy and are more physically active than others have significantly lower incidences of seizures, lower levels of depression and an improved quality of life.

### Caution in sports

Although physical activity is beneficial, people who have uncontrolled or frequent seizures should be cautious when playing certain sports. Factors such as fatigue, stress of competition, hypoxia, hyperthermia and hypoglycaemia can severely effect epileptics.

## Recommended readings

http://www.epilepsy.org.au/about-epilepsy

## Reference list

* 1 2 Duncan, J. S., Sander, J. W., Sisodiya, S. M., & Walker, M. C. (2006). Adult epilepsy. Lancet, 367(9516), 1087-1100.,
* 1 2 3 4 Sarah Goodman 2008, "Epilepsy: diagnosis and management", Practice Nurse, vol. 35, no. 1, pp. 18.
* ↑ Douw L, de Groot M, van Dellen E, Heimans JJ, Ronner HE, et al. (2010) ‘Functional Connectivity’ Is a Sensitive Predictor of Epilepsy Diagnosis after the First Seizure. PLoS ONE 5(5): e10839. doi:10.1371/journal.pone.0010839.
* 1 2 Epilepsy Action Australia. [Online] Available at <http://www.epilepsy.org.au/about-epilepsy/medical-aspects/treatment >. [Accessed 21st October 2013]
* 1 2 Saxena, V.S. & Nadkarni, V.V. 2011, "Nonpharmacological treatment of epilepsy", Annals of Indian Academy of Neurology, vol. 14, no. 3, pp. 148-152.
* 1 2 3 4 Arida, R.M., Scorza, F.A., da Silva, S.G., Schachter, S.C. & Cavalheiro, E.A. 2010, "The potential role of physical exercise in the treatment of epilepsy", Epilepsy and Behavior, vol. 17, no. 4, pp. 432-435.
* 1 2 3 Arida, R.M., Cavalheiro, E.A., da Silva, A.C. & Scorza, F.A. 2008, "Physical Activity and Epilepsy: Proven and Predicted Benefits", Sports Medicine, vol. 38, no. 7, pp. 607-615.