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. NES 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 NES, 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 NES 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 CP.
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.