Can slow breathing exercises improve seizure control in people with refractory epilepsy? A hypothesis.

Studies on various medical conditions have shown that poor health is associated with lower parasympathetic tone. People with epilepsy appear to have decreased parasympathetic tone, with a greater decrease in those with intractable seizures than in those with well-controlled epilepsy. Slow breathing exercises have been shown to increase parasympathetic tone in healthy volunteers. Slow breathing exercises have been shown to improve a number of medical conditions including asthma, hypertension, anxiety states, and posttraumatic stress disorder. We hypothesize that slow breathing exercises in people with epilepsy can lead to an increase in parasympathetic tone and an accompanying reduction in seizure frequency. The slow breathing exercises, probably through baroreceptors, chemoreceptors, and pulmonary stretch receptors, affect cortical activity and hence seizure thresholds. It is also possible that slow breathing exercises might reduce seizure frequency by reducing anxiety. The hypothesis can be tested by employing devices and protocols that have been used to reduce breathing rates and have been shown to improve health outcomes in other medical conditions. Copyright © 2010 Elsevier Inc. All rights reserved.