Seizures Induced by Physical Exercise: Report of Two Cases

Abstract

Two children with seizures induced by physical exercise are described. Epilepsy was present from early childhood (age: 4 and 5 months), but the precipitating effect of exercise became evident only later (age: 20 months and 3.5 years). Several treatment regimes were tried, but no satisfactory seizure control could be achieved. In both children no etiological factor was known. MRI, CT and repeated interictal waking and sleeping EEG recordings were normal. Hyperventilation and photostimulation had no effect on the EEG. Physical exercise (e.g., playing football) induced clinical seizures and generalized epileptiform EEG abnormalities as recorded by ambulatory cassette EEG (Oxford). Cardiac arrhythmias were excluded by concomitant EEG recording. Extensive metabolic and endocrinologic investigations during and after seizure induction gave normal results. Thus, the pathophysiologic mechanism for exercise-induced seizures remained unclear.

Can an exercise bicycle be safely used in the epilepsy monitoring unit?: An exercise method to provoke epileptic seizures and the related safety issues

“…Some recent literatures suggested that exercise reduces seizure frequency or does not increase seizure frequency [15,16]. By contrast, some studies reported that exercise such as riding the bicycle, playing football, and running induced a seizure [6,[17][18][19].…”

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“…De manera excepcional se ha documentado que pocas personas con la enfermedad desarrollan crisis provocadas por la actividad física (84)(85)(86)(87)(88)(89)(90). Arida y colaboradores (91) relacionan la aparición de estos eventos con alteraciones homeostáticas asociadas a fatiga, estrés, hipoxia, hipoglicemia, hiperhidratación, hiponatremia o hipertermia.…”

Alternative approaches to conventional antiepileptic drugs in the management of paediatric epilepsy

“…23 There are also case reports of seizures induced by exercise in children. 24 Exercise is difficult for many children with epilepsy due to their motor problems and learning disabilities, but this should not preclude their attempts to participate in games and sports activities whenever possible.…”