For people experiencing epilepsy, lifestyle changes may be the key to improving seizure control. While more research needs to be done, early evidence suggests that some lifestyle modifications and stress-reducing techniques may be helpful for epilepsy when practiced in combination with taking anti-seizure medication.
Exercise improves overall health, and in most cases does not worsen seizures. Some physical activity may even help reduce seizures for some people. Before starting a new exercise program, talk with your neurologist about what sports and activities would be safe for you.
Examples of low-risk sports include basketball, soccer, running, walking or dance, while higher-risk sports include climbing, diving, or horseback riding. Swimming can be safe if it is always practiced in the presence of an attentive lifeguard or other capable adult swimmer.
Yoga may be an especially helpful form of low-risk physical activity because it incorporates stress-reducing techniques, although an analysis in 2017 indicated that more high-quality research is needed to determine these effects on the treatment of epilepsy.
Emotional and Psychological Support
Epilepsy may occur in conjunction with stress, anxiety and depression. Research published October 2017 shows that cognitive behavioral therapy, or CBT, can be helpful because of its focus on mindset and behavioral changes to adapt to stress. CBT may lead to a reduction in seizure frequency in some patients. Additionally, in many cases, CBT can improve quality of life, emotional well-being, fatigue and depression.
Mindfulness and meditation, counseling and educational programs have also shown promise. Based on the available research, the International League against Epilepsy recommended in 2018 that physicians regularly incorporated strategies for psychological well-being into the care of people with epilepsy.
In the 1990s, it was recognized that listening to certain musical compositions may enhance thinking ability. Since then, this “Mozart effect” has been studied in a variety of neurological conditions. For people with epilepsy, limited research suggests that music therapy may result in reduced seizures and decreased epilepsy-related abnormalities on EEG.
Dietary therapy may offer varying degrees of benefit for people with epilepsy. These therapies include diets that are high in fat, adequate for protein and low in carbohydrates. The ketogenic diet is the strictest form. While it’s most likely to significantly reduce seizures, the keto diet is also the most difficult dietary therapy options to manage and maintain.
Alternatives include the modified Atkins diet, medium-chain triglyceride diet and low-glycemic index treatment. One study from the UK, published in 2020, shows that these forms may also result in seizure reduction, although less consistently than with the ketogenic diet.
This treatment involves specific placement of thin needles into the body, and has been studied for treatment of epilepsy, with variable results. A review in 2014 did not support acupuncture as a treatment for epilepsy, while in a 2021 study, a team of researchers from Brazil found a reduction in seizures for a group of patients with temporal lobe epilepsy.
More research is necessary before a conclusion can be reached about the benefits of acupuncture for epilepsy.
While each of these approaches holds promise, more research is clearly needed. A new study at the Cleveland Clinic Charles Shor Epilepsy Center is investigating the effect of multiple lifestyle interventions on seizure control and epilepsy-associated health concerns in adults with difficult-to-treat epilepsy.
Up to 1,000 patients will be enrolled and three groups will be compared. The first group will receive yoga therapy and meditation, music therapy or cognitive behavioral therapy; the second group will receive typical epilepsy treatment; And the third group will receive their typical epilepsy care plus regular phone check-ins with a study coordinator.
Patients will keep daily seizure logs and complete health questionnaires at three, six and 12 months to assess seizure frequency and overall health, sleep quality, mood, quality of life, stress, anxiety and depression. Patients will also participate in brief neuropsychological testing to measure attention, processing speed, language, decision making, memory and visuospatial skills.
The hope is that this study and other larger studies will provide results that can empower patients with epilepsy and their caregivers to safely and securely their physical, emotional and cognitive health optimization.