Respiration and seizure control-abstracts

[Zoe]

These are two abstracts of Fried's studies I mentioned in the virus thread:

1: Ann N Y Acad Sci. 1990;602:67-96.

Effect of diaphragmatic respiration with end-tidal CO2 biofeedback on
respiration, EEG, and seizure frequency in idiopathic epilepsy.

Fried R, Fox MC, Carlton RM.

Hunter College, City University of New York, New York 10021.

Breathing rate (RR), end-tidal percent CO2, and EEG were obtained in three
groups: psychiatric referral subjects presenting with anxiety, panic phobia,
depression and migraine; a group of idiopathic seizure sufferers; and a group of
asymptomatic controls. Virtually all the noncontrol subjects were found to show
moderate to severe hyperventilation and the accompanying EEG dysrhythmia. The
seizure group subjects were taught diaphragmatic respiration with end-tidal
percent CO2 biofeedback. The training normalized their respiration and altered
their EEGs and seizure frequency.

PMID: 2122789 [PubMed - indexed for MEDLINE]

Related Links

Behavioral control of intractable idiopathic seizures: I. Self-regulation of
end-tidal carbon dioxide. [Psychosom Med. 1984] PMID:6435147

Control of the end-tidal PCO2 in the hyperventilation syndrome: effects of
biofeedback and breathing instructions compared. [Bull Eur Physiopathol Respir.
1982] PMID:6821472

Unsteadiness of breathing in patients with hyperventilation syndrome and anxiety
disorders. [Eur Respir J. 1997] PMID:9032511

Respiratory psychophysiology of panic disorder: three respiratory challenges in
98 subjects. [Am J Psychiatry. 1997] PMID:9356564

[Electrical picture of the brain under increased respiration in children. Studies
on the structure of hyperventilation and its value as a provocation method in
clinical electroencephalography in a model of multivariate analysis using
electronic data processing] [Psychiatr Neurol Med Psychol Beih. 1971]
PMID:5006298

--------------------------

1: Psychosom Med. 1984 Jul-Aug;46(4):315-31.

Behavioral control of intractable idiopathic seizures: I. Self-regulation of
end-tidal carbon dioxide.

Fried R, Rubin SR, Carlton RM, Fox MC.

Eleven women and seven men with moderate to severe chronic hyperventilation and
idiopathic seizures refractory to therapeutic serum levels of anticonvulsant
medication were given diaphragmatic respiration training with percent end-tidal
CO2 biofeedback. The training had a rapid correcting effect on their respiration,
making it comparable to that of 18 asymptomatic control subjects. Ten of the
seizure-group subjects were in the study at least 7 months and following
treatment, 8 showed EEG power spectrum "normalization", restoration of
cardio-respiratory synchrony (RSA), and their seizure frequency and severity were
significantly reduced.

PMID: 6435147 [PubMed - indexed for MEDLINE]

Related Links

Effect of diaphragmatic respiration with end-tidal CO2 biofeedback on
respiration, EEG, and seizure frequency in idiopathic epilepsy. [Ann N Y Acad
Sci. 1990] PMID:2122789

Clinical efficacy of galvanic skin response biofeedback training in reducing
seizures in adult epilepsy: a preliminary randomized controlled study. [Epilepsy
Behav. 2004] PMID:15123023

Double-blind, randomized controlled pilot study of bilateral cerebellar
stimulation for treatment of intractable motor seizures. [Epilepsia. 2005]
PMID:16026559

EEG biofeedback and relaxation training in the control of epileptic seizures.
[Int J Psychophysiol. 1988] PMID:3136105

Control of the end-tidal PCO2 in the hyperventilation syndrome: effects of
biofeedback and breathing instructions compared. [Bull Eur Physiopathol Respir.
1982] PMID:6821472
---------------
This link is to related studies on PubMed

http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum

[brain]

Interesting ZOE,

But those were just a few people
when you have over 5 million people
worldwide? Most Neuroscience Professors
would have thrown that out and stated
that a case does not make.

For them a case would need to be something
like a study done with 300-500 people
with an almost equal ratio if all possible
of men and women alike.

That's the reason why I don't post links
or publications or articles or journals based
on a few people, even though it's an
interesting study, but when you look
at the overall perspective of how many
people are OUT THERE as a whole, that
percentage equals almost next to nothing
or .001%

Now if that article had:
211 women and 177 men
That would be a different story there
See the difference now?

[Zoe]

Hi Brain,
First of all, I wasn't making a case, but making a point. I mentioned it was a small study and it should have been obvious this shouldn't be construed as making a case. Sorry if it wasn't clear.
The reason you are often asked to hyperventilate during an EEG is because making yourself breathe rapidly can trigger a seizure. Involuntarily hyperventilating (or hypoventilating) can also trigger a seizure. Anything that can provoke an increase in your respiration rate, or a decrease (such as with hypotension), can trigger a seizure. Learning to control one's respiration to gain more self control of seizures has been fairly well researched, more recently in the practice of yoga. Just like drugs, what works for one, doesn't always work for others.
Changes in heart rate, cerebral blood flow, and respiration are symptoms of seizures. These are just some of the physical changes that take place during seizure onset. If nothing changed, there'd be no seizure. The changes can be positively altered, such as with neurofeedback, to improve seizure control.
Sometimes folks get locked into the idea that nothing they can do will influence their seizures in any way and this simply is not true. How we sleep, what we eat, what we choose to drink, and how we breathe certainly does influence our seizures.
When I was having three and more seizures a day, and there were no other drugs to try after brain surgery had failed, I felt pretty helpless. Meeting a psychologist who taught me something that seemed so simple, controlling my breathing and heart rate, set me on a five year path to overcoming my intractable seizures.
Whether someone overcomes their seizures or not, learning breath control exercises is just one of many methods that can raise the seizure threshold. We are not as helpless as we are sometimes led to believe.
Zoe

[RobinN]

For me even the smallest studies are welcome, because they are just one more option for the many folks that do not fit a profile. I understand those that have had seizures their whole life would more than likely know all of this info, or have tossed out ideas that do not fit their needs. For me, being able to teach my daughter breathing techniques is one more piece of info that I can suggest to her.
Yes, Zoe, sometimes I do feel helpless.

A piece of news about breathing techniques... I can stop hiccups with a certain breathing technique that I came up with. Works every time for me.

Breathing also always puts me to sleep. Breath 4 counts in, hold for 7, breath 8 counts out. Repeat 10 times (I have never had to do a second set of 10).

[execwife2002]

Interesting breathing technique Robin. I myself will try it tonight when I go to sleep.
Marian

[Zoe]

Robin,
That sounds like a good technique. It is so difficult to be watching someone seize and feel helpless to do anything about it. A psychologist pointed out that it is only those few moments during the seizure we are out of control, but not the rest of the time. Have you read the book, "Epilespsy: A New Approach," by Richards and Reiter? They have a whole chapter on stopping seizure strategies. I think it is something that will give you ideas and hope at this time and your daughter too.
Zoe

[Zoe]

p.s. What I admire about the book I just mentioned and the approach they take at the Andrews\Reiter program, is the focus is helping people learn specific strategies for managing seizures on their own. If your daughter is interested, she may want to look into yoga classes, specifically the breathing techniques which have been studied for seizure control too. Yoga is very adapatble to disabilities and I have found teachers who are very good on this. She would want to explain to the instructor beforehand her situation and maybe ask for some special attention to learning the deep diaphragmatic breathing if she wants to try this. If having seizures is undermining her self-confidence maybe learning yoga will offset this.
Zoe

[RobinN]

Yes I have a brochure here on my desk about Yoga classes. They have something called Energy Training, and they have a private healing session that says it will identify and heal deeply rooted causes of physical and emotional stress and illness.

Luckily she is able to continue with her figure skateing which helps her with her self-confidence most of the time. She is also a dancer, so the yoga is a good addition to this type of self expression. I just get overwhelmed with the time commitments.

Are you familiar with Andrews/Reiter program?
I sent and email asking about 15/16 yr olds in the program over two weeks ago and have not heard back. I see on their website that it is just an adult program right now, with children being accepted into the program at a later date. I am not sure if this is current info.

[RobinN]

BTW Marion,
I can not take credit for that breathing technique. I learned it from an Andrew Weil article or book.

[brain]

That is why I posted that post.
If there had been more people involved;
which I wished there were - it would have
sustained the attention of the Neurology
field; but oh no!

For some reason Neuroscience doesn't
seem to comprehend or grasp these
neurofeedback, yoga, or even other
simple things such as biofeedbacks - which
DO work. They admit it that it does work
on some patients, but they shy away from
it. That itself I find baffling.

Sorry if I came across in a wrong approach,
and people get the message as I'm coming
across the wrong way when I'm not. I
hope this repost above makes it a little bit
more clearer.

To me - personally - there seems to be an
obsession with Neuroscience and Technology
and/or Pharmacology; at least that's how it's
all coming to me as.

If you were to see a Cardiologist for example;
they would direct you to leading into a more
healthier lifestyle naturally in a non-invasive
manner for example ~ yoga, exercise, etc.
But come Neurology paints a different picture.

I hope I come across a different perspective
this time around.

That's why I don't post links with just a few
individuals as Neuroscience folks are out there
and lurking - I'd rather they see massive results
and response, even if it's an abstract article,
and have the folks slam it in their faces and
say "It's so!"

That's the point I was trying to make - my
apologies if anyone misunderstood my original
post. I'll try harder to be more clarified the
next time around with more specifics and
reasons. Okie Dokie?

[Bernard]

brain, no need to apologize. Everyone reading the forum should keep all information in perspective and you did a good job highlighting a consideration of the referenced studies.

Zoe & Robin, I think when you post references to studies, it would really help clarify what point you are trying to get across if you precede the citation with your own personal commentary/thoughts/opinions/etc.

[John-Forrest]

Ultimately, what works or does not work depends on YOU! I find this string about respiration revealing. For one thing, it may explain why I often find myself having a "wipe-out" when I've been exerting myself climbing up a steep trail or riding up a steep hill on my bicycle; I've been hyperventilating.

I personally find it soothing to my brain to sit still and deliberately breathe in very deeply (ten seconds), holding the breath ten seconds, then breathe out ten seconds. It is also very useful to do the same while breathing in and out one nostril while holding other nostril closed - then switch to the other nostril. (A standard yoga practice.) This generally gets me out of a panic attack or more relaxed before a big stressor (i.e. an important meeting).

[RobinN]

So true, John. There are so many reasons that this darn E grabs ahold of folks. Some studies certainly aren't going to show that which will be positive therapies for a few.

I am remembering to use breathing as a daily gift to myself. Just like I need water, I also need to have cleansing breaths through the day. Though I haven't tried the one nostril approach. Seems like I need to go to those yoga classes that I keep saying I will go to.

Glad to know that it works for you.