[Info] Stop seizures with a simple breath exercise

[Artour]

This breathing exercise has been used by hundreds of epileptics with great success. Start this breathing exercise as soon as you anticipate or feel that something wrong is going to happen with your body and/or mind (before it's too late!). Stress, fear and anxiety often trigger ineffective breath pattern (less oxygen for the body). Breathing usually becomes even deeper or more irregular, and fast too. These are symptoms of breathing too much. CO2 losses will trigger seizures.

Your goal is opposite. Breathe regularly and only through the nose, but only while taking small or short inhalations using the diaphragm, instead of taking your large and quick inhales using the chest muscles. In order to exhale just relax the diaphragm and count for about 3 seconds for each exhale. You have to breathe regularly all the time during this exercise.

Due to breathing less (shallow or reduced breathing), you should get air hunger or desire to breathe more. It should appear in some seconds after you start the exercise. Maintain this air hunger so that extra carbon dioxide in your blood and brain will calm down the overexcited nerve cells and lessen their threshold of excitability closer to normal numbers. CO2 will also improve blood delivery for the brain. Improved blood supply to the brain will raise oxygen and glucose transport and increase CO2 content in the brain as well. This is the physiological mechanism and cause of success for this exercise.

What will help (additional factors for success)

Epileptics are chest breathers. This reduces blood oxygenation. Lower parts of the lungs do not get new oxygen. Hence, the success rate for this exercise is much higher, if you can employ your belly or abdomen for your inhalations, not chest.

Note that mouth breathing worsens symptoms of seizures and can lead to more severe types of seizures. Hence, you should take care about nasal breathing 24/7 or long before you get any signs of seizures. Find and use this free internet manual "How to maintain nasal breathing 24/7".

can do the same trick

[Rae1889]

Well during a hyperventilation part of the EEG, I wasn't affected, so breathing fast and deep doesn't affect all epileptics.

Second, I have a hard time reacting to an aura or simple partial in general. Its not like I think immediately, omg I'm having an aura. Its usually that I'm distracted by what's going on that I can't do anything to stop it. A few times I can tell people that I'm suddenly not feeling great. But by that time I'm usually in a full blown seizure or unresponsive.

[Bernard]

Hi Artour, welcome to the forum.

Breathing exercises are part of the CBT / neurobehavioral techniques used by the Andrews-Reiter clinic and others.

Deep breathing and the role of CO2 has also been discussed quite a bit in the forums, but I don't recall seeing anyone offer specific recommendations like you have.

It is worth a try for those who experience auras or otherwise have some awareness when their seizure threshold is low. Appreciate the tip on breathing with the diaphram - reminds of that scene in Remo Williams when Chiun chastizes Remo for breathing with his chest.

[Cint]

From "Science Daily":

Brain Pathway That Shuts Down Seizures Identified

ScienceDaily (June 10, 2008— Researchers at the University of Iowa and the Veterans Affairs Iowa City Health Care System have uncovered a brain pathway that shuts down seizures.

The link between low pH in the brain and seizure termination was first hinted at nearly 80 years ago when clinical experiments showed that breathing carbon dioxide, which makes brain tissue more acidic, helps stop epileptic seizures. Subsequent studies in the 1950s found that seizures themselves reduce brain pH. However, it was the modern discovery of an acid-activated ion channel (ASIC1a) in the brain that provided the key to the UI discovery, which is reported in Nature Neuroscience Advance Online Publication on June 8.

"We found that ASIC1a does not seem to play a role in how a seizure starts, but as the seizure continues and the pH is reduced, ASIC1a appears to play a role in stopping additional seizure activity," said Adam Ziemann, a student in the Medical Scientist Training Program at the UI and co-lead author of the study.

Specifically, the study shows that mice without the ASIC1a gene have more severe and longer seizures than mice with the gene. In addition, chemically blocking ASIC1a increases the severity and duration of seizures in mice with the gene. Conversely, increasing the expression of ASIC1a in mice protects the animals from severe seizures.

The team also showed that reducing the pH in slices of brain tissue expressing ASIC1a reduced seizure activity, but acid had no effect on seizures in tissue without the protein.
When the team measured pH in mouse brains, they showed that seizures lower the pH to levels that can activate ASIC1a channels. They also found that breathing carbon dioxide causes an additional rapid drop in brain pH, and that breathing 10 percent carbon dioxide was sufficient to protect mice with the ASIC1a protein from lethal seizures.

"In seizures, ASIC1a appears to be activating inhibitory neurons," explained John Wemmie, M.D., Ph.D., senior study author and assistant professor of psychiatry in the UI Roy J. and Lucille A. Carver College of Medicine, and a staff physician and researcher at the VA Iowa City Health Care System. "This is the first study to show that ASIC1a activation can have an inhibitory effect."

"One of the most exciting aspects of the work is that it highlights the potent anti-epileptic effects of acid in the brain -- effects that have been recognized for nearly 100 years but until recently have been poorly understood -- and it identifies ASIC1a as a key player in mediating the anti-epileptic effect of low pH," Ziemann said.

"We don't know yet, but presumably there might be examples where the seizures don't stop because of a deficit in this pathway," Wemmie added.

"The discovery helps explain why breathing carbon dioxide stops seizures, which might stimulate the use of carbon dioxide for stopping seizures, Wemmie said. "However, although this work provides insight into how seizures normally stop and might help us learn more about how to terminate those seizures that don't stop, it will take more work to turn the finding into a new therapeutic approach. We will be working with colleagues in neurology and neurosurgery to try and translate the findings to treatments."

Story Source:
The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Iowa

It will be great when they find a way to terminate those seizures that don't stop, like the ones some of us experience day AND night.

[tkopi]

I have noticed that at the first start of an aura I usually haven't breathed for a while. It's like I just stop breathing without realizing it and if I catch it soon enough and take some deep breaths and consentrate on my breathing it will leave and I'll be fine. I'm really going to have to work on this breathing exersize more. thanks

[Artour]

Thank you, Bernard and others for input.

I teach breath work for about 7 years and have one of the largest site (NormalBreathing.com) about the Buteyko technique. I had students with epilepsy who retrained their breathing up to 30 seconds for the body oxygenation test (Control Pause) and their seizures disappeared completely. Russian Buteyko doctors claimed the same.

The hard part with epileptics is that oxygen (rather hypoxia) plays a role in seizures too, not just CO2 as in stopping asthma attacks. So, breathing should be regular, but with very small diaphragmatic inhalations and longer exhales. Gradual breathing retraining, in my view, is the way to deal with epilepsy-seizures.

There is a special Epilepsy Web Page there with some resources including how to prevent/reduce sleep seizures at night. As about CO2 effects, see the abstracts below. If hyperventilation and hypocapnia trigger seizures, breathing normalization will reduces/eliminate them.

If any epileptics tries this reduced breathing all the time, the duration and severity of seizures, if any, will be much less.


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References and quotes (Overbreathing and irregular breathing trigger seizures)
Arain AM, Arbogast PG, Abou-Khalil BW, Utility of daily supervised hyperventilation during long-term video-EEG monitoring, J Clin Neurophysiol. 2009 Feb;26(1):17-20.
Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. amir.arain@vanderbilt.edu
Hyperventilation (HV) is most effective in activation of generalized absence seizures during routine EEG studies...

J ECT. 2008 Sep;24(3):195-8.
Moderate hyperventilation prolongs electroencephalogram seizure duration of the first electroconvulsive therapy.
Sawayama E, Takahashi M, Inoue A, Nakajima K, Kano A, Sawayama T, Okutomi T, Miyaoka H.
Department of Psychiatry, Kitasato University School of Medicine, Sagamihara, Japan. enami@kitasato-u.ac.jp
Abstract
Although it is controversial that seizure duration can influence the efficacy of electroconvulsive therapy (ECT), a missed or brief seizure is considered less effective ECT. Of the background in the practice of ECT, hyperventilation may augment the seizure duration. To elucidate these hypotheses, we performed double-blind randomized controlled trial for 19 patients. They were divided into 2 groups, according to the end-tidal pressure of carbon dioxide (ETCO2): The moderate hyperventilation group with ETCO2 of 30 mm Hg and the normal ventilation group with ETCO2 of 40 mm Hg. ECT was performed under general anesthesia with propofol and suxamethonium. During ECT electroencephalogram (EEG) and electromyogram were recorded. The Global Assessment of Functioning scores were also analyzed before and after 6 sequential ECT. The moderate hyperventilation group showed a significant increase in EEG seizure duration in the first treatment compared with the normal ventilation group (P < 0.05)...

Silva W, Giagante B, Saizar R, D'Alessio L, Oddo S, Consalvo D, Saidón P, Kochen S, Clinical features and prognosis of nonepileptic seizures in a developing country, Epilepsia. 2001 Mar;42(3):398-401.
Municipal Epilepsy Center, Department of Neurology, Ramos Mejía Hospital, and CONICET, Buenos Aires, Argentina. skochen@mail.retina.ar
PURPOSE: To determine the predictive value of clinical features and medical history in patients with nonepileptic seizures (NESs). METHODS: One hundred sixty-one consecutive ictal video-EEGs were reviewed, and 17 patients with 41 NESs identified. non-epileptic seizures diagnosis was defined as paroxysmal behavioral changes suggestive of epileptic seizures recorded during video-EEC without any electrographic ictal activity. Clinical features, age, sex, coexisting epilepsy, associated psychiatric disorder, social and economic factors, delay in reaching the diagnosis of non-epileptic seizures, previous treatment, and correlation with outcome on follow-up were examined. RESULTS: The study population included 70% female patients with a mean age of 33 years. Mean duration of NESs before diagnosis was 9 years. Forty-one percent had coexisting epilepsy. The most frequent non-epileptic seizures clinical features were tonic-clonic mimicking movements and fear/anxiety/hyperventilation...

Paediatr Drugs. 2001;3(5):379-403.
Treatment of typical absence seizures and related epileptic syndromes.
Panayiotopoulos complex partial.
Department of Clinical Neurophysiology and Epilepsies, St Thomas' Hospital, London, England. tom.panayiotopoulos@gstt.sthames.nhs.uk
Typical absences are brief (seconds) generalised seizures of sudden onset and termination. They have 2 essential components: clinically, the impairment of consciousness (absence) and, generalised 3 to 4Hz spike/polyspike and slow wave discharges on electroencephalogram (EEG). They differ fundamentally from other seizures and are pharmacologically unique. Their clinical and EEG manifestations are syndrome-related. Impairment of consciousness may be severe, moderate, mild or inconspicuous. This is often associated with motor manifestations, automatisms and autonomic disturbances. Clonic, tonic and atonic components alone or in combination are motor symptoms; myoclonia, mainly of facial muscles, is the most common. The ictal EEG discharge may be consistently brief (2 to 5 seconds) or long (15 to 30 seconds), continuous or fragmented, with single or multiple spikes associated with the slow wave. The intradischarge frequency may be constant or may vary (2.5 to 5Hz). Typical absences are easily precipitated by hyperventilation in about 90% of untreated patients...

Marrosu F, Puligheddu M, Giagheddu M, Cossu G, Piga M, Correlation between cerebral perfusion and hyperventilation enhanced focal spiking activity, Epilepsy Res. 2000 Jun;40(1):79-86.
Institute of Neurology and Department of Nuclear Medicine, Faculty of Medicine, University of Cagliari, Via Ospedale, 54 09100, Cagliari, Italy. marrosu@vaxca1.unica.it
... Hyperventilation (HPV) represents a well established EEG activation procedure aimed at enhancing epileptiform discharges...

Clin Electroencephalogr. 1993 Jan;24(1):1-5.
Transcranial magnetic stimulation (TMS) of the brain in patients with mesiotemporal epileptic foci.
Steinhoff BJ, Stodieck SR, Zivcec Z, Schreiner R, von Maffei C, Plendl H, Paulus W.
Department of Neurology, Ludwig-Maximilians-Universität, Munich, Germany.
Abstract
Transcranial magnetic stimulation (TMS) of the human brain is mainly used for the diagnosis of diseases with disturbed central motor conduction. Recent studies revealed controversial results concerning the possibility of a TMS-induced specific activation of epileptogenic foci in patients with localization-related epilepsies, which would make TMS an additional diagnostic tool for the presurgical localization of the primary epileptogenic zone. We applied TMS to 19 patients with complex-partial seizures and investigated its effects and safety. In 12 patients we performed TMS during scalp electroencephalogram (EEG) recordings. The remaining 7 patients with localization-related epilepsies of mesiobasal limbic seizure origin underwent EEG with additionally implanted foramen-ovale-electrodes (FOE). We did not notice any significant spike activation and even observed bilateral reduction of epileptic activity in some patients. On the contrary, hyperventilation induced a marked activation of the epileptic focus. Our findings support that TMS is safe since adverse effects did not occur. However, due to possible safety hazards, TMS in epileptic patients still requires cautious application until more data will be available.

Bergsholm P, Gran L, Bleie H, Seizure duration in unilateral electroconvulsive therapy. The effect of hypocapnia induced by hyperventilation and the effect of ventilation with oxygen, Acta Psychiatr Scand. 1984 Feb;69(2):121-8.
Seizure duration in unilateral electroconvulsive therapy (ECT) was recorded by means of EEG in an intraindividual comparison under different alveolar O2- and CO2-concentrations. Hypocapnia induced by hyperventilation to an alveolar CO2-concentration of 2% (2 kPa) resulted in a highly significant increase in seizure duration compared to a normal CO2 of 5%, when the alveolar O2-concentration was constant at 92%. Oxygen ventilation to an alveolar O2-concentration of 92% gave no significant increase in seizure duration compared to 15%, obtained by ventilation with air, when the CO2-concentration was kept constant at 5%. Seizure duration seems to augment progressively with decreasing alveolar CO2-concentration.

Neurol Neurochir Pol. 1981 Sep-Dec;15(5-6):545-52.
[Effect of physical exertion on seizure discharges in the EEG of epilepsy patients]
[Article in Polish]
Horyd W, Gryziak J, Niedzielska K, Zielinski JJ.
Abstract
The purpose of this study was establishing the effect of moderate exercise on EEG tracings in young epileptics. The model of graded exercise was 15-minute work on a cycle ergometer. The effect of the exercise on the pattern of simultaneously recorded EEG was compared with the effect of 3-minute hyperventilation. After testing a control group of 20 young subjects without evidence of organic brain damage or with this damage causing no epilepsy another group of 43 epileptics was studied. In none of these patients the intensity of changes in EEG increased during the exercise but evident EEG differences could be detected during different stages of the exercise in 28 patients with significant generalized discharges. It was found that during the exercise in nearly all patients the number of discharges decreased while during hyperventilation it increased. In 10 patients in this group a repeated rise in the number of discharges was observed immediately after the exercise which was connected usually with greater fatigue after the exercise. In the light of these results the authors conclude that moderate exercise inhibits rather seizure activity in EEG contrary to hyperventilation which increases these changes.
Absrtacts (Western doctors who treated absence spells and seizures with breathing techniques)

Magarian GJ, Olney RK, Absence spells. Hyperventilation syndrome as a previously unrecognized cause, Am J Med. 1984 May;76(5):905-9.
Absence spells in adults have been recognized in association with disorders of excessive somnolence, transient ischemia of the temporal lobes, and seizure disorders. A 66-year-old man who presented with a history of absence spells for more than 20 years is described. After diagnosis of a hyperventilation syndrome without an associated seizure disorder, educational and behavioral therapy without the use of medication has produced a long, continuing remission of these spells. The hyperventilation syndrome continues to present in many ways, often without recognition by physicians for prolonged periods. The case presented exemplifies this problem and may be the first report of absence spells caused by hyperventilation.

Bruno-Golden B, Holmes GL, Hyperventilation-induced seizures in mentally impaired children, Seizure. 1993 Sep;2(3):229-33.
Boston Neurobehavioral Institute, Harvard Medical School, Children's Hospital, MA 02115.
Two children with profound development delay and medically intractable seizures were found to have hyperventilation-induced seizures. Following detection of this precipitating factor the parents, teachers and caretakers were taught to modify the childrens' breathing when they began to hyperventilate. In both patients this technique resulted in a dramatic decrease in seizure frequency.

Fried R, Rubin SR, Carlton RM, Fox MC, Behavioral control of intractable idiopathic seizures: I. Self-regulation of end-tidal carbon dioxide, Psychosom Med. 1984 Jul-Aug;46(4):315-31.
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.

[Bernard]

... There is a special Epilepsy Web Page there ...

http://normalbreathing.com/diseases-stop-seizures.php

[Lainsta]

Very cool theory!!! I am very aware of how shallow i breathe and i'm always trying to pull myself up on it and change it into deeper breathing from my abdomen.
Now that i'm reading that it could stop the seizures, i'm even more keen

Thanks for the info!

[Artour]

Yes, the ideal breathing for maximum body oxygen content and to prevent seizures is very deep breathing in terms of mechanics (you use lowest parts of the diaphragm), regular, very slow , and absolutely tiny in terms of tidal volume (only one small gulp of air per one breath at rest).
Deep unconscious or conscious breathing (with large tidal volume) and normal frequency will make seizures longer and worse.

[Lainsta]

hmmmmmmmm confusing so deep abdomen breathing isnt such a good technique?
How many secs when starting do you count on an in breath?

[Bernard]

I think it's a bit confusing because the word deep can mean more than one thing.

1. deep breathing = breathing from the diaphram (deep in the body)
2. deep breathing = breathing deeply (to full capacity on each breath)

I think Artour is advocating #1, but not necessarily #2.

[Artour]

Yes, Bernard is absolutely right.
When I write about breathing I mean unconscious or automatic breathing patterns. It is not some breath work, but how you breathe for remaining 23 hours of the day, especially during early morning hours (with highest chances of seizures), that matters most. For analysis of breathing pattern visit a web page from NormalBreathing.com

[Lainsta]

Just logged on to normalbreathing site.
It all makes sense to me!!!!

It's, as you say, learning how to breathe a certain way for the other 23 plus hours a day.
Artour DO you take breathing seminars? or have you done them yourself and that's how you know this stuff

[Artour]

Visit my website and you will get many answers about seizures, breathing, my teaching, etc.: NormalBreathing.com

[sandi]

Thanks for the info It may help some, I 'm in to deep to control by the time I figure it out!
Then again hurting myself like pinching or slamming my hand in the door has sometime stalled a spell a few seconds more for me to get safely on the floor