Yoga for epilepsy

Background: Stress is considered an important precipitating factor for seizures. Yoga is believed to induce relaxation and stress reduction. The effect of yoga on the electroencephalogram and the autonomic nervous system has been reported. Yoga would be an attractive therapeutic option for epilepsy (if proved effective), in view of its non pharmacological nature, minimal adverse effects and international acceptance.

Objectives: To assess the efficacy of yoga in the treatment of people with epilepsy.

Search strategy: We searched the Cochrane Epilepsy Group trial register (16/9/02), the Cochrane Controlled Trials Register (Cochrane Library Issue 3, 2002), MEDLINE (16/9/02) for articles published up to the July 2002, and also registries of the research council for complementary medicine. In addition, we searched the references of all the identified studies.

Selection criteria: Randomized control trials and controlled clinical trials of treatment of epilepsy with yoga.

Data collection and analysis: Two reviewers independently selected trials for inclusion and extracted data. Outcomes investigated included: percentage of people rendered seizure free; seizure frequency and duration. Analyses were on an intention-to-treat basis.

Main results: Only one study with 32 participants met the inclusion criteria, 10 to sahaja yoga and 22 to control. Antiepileptic drugs were continued in all. Randomization was by roll of a dice. The results of this study are as follows:(i) seizure free for six months - the odds ratio (OR) with 95% confidence intervals (CIs) for yoga versus sham yoga group was 14.5(95% CI 0.7 to 316.7) and for yoga versus no treatment group 17.3(95% CI 0.8 to 373.5);(ii) more than 50% reduction in seizure frequency - the OR for yoga versus sham yoga group was 81(95% CI 4.4 to 1504.5) and for the yoga versus no treatment group was 158.3(95% CI 5.8 to 4335.9);(iii) reduction in seizure frequency - the weighted mean difference between yoga versus sham yoga group was -2.1(95% CI -3.1 to -1.0) and for the yoga versus no treatment group -1.1(95% CI -1.8 to -0.4);(iv) more than 50% reduction in seizure duration - the OR for yoga versus sham yoga group was 45(95% CI 2.0 to 10006.8) and for yoga versus no treatment group 53.57(95% CI 2.4 to 1187.3).

Reviewers' conclusions: No reliable conclusions can be drawn regarding the efficacy of yoga as a treatment for epilepsy. Further studies are needed.