Priority 16 from the Epilepsy (Canada) PSP

UNCERTAINTY: What non-drug lifestyle treatments (e.g., cardiovascular exercise, yoga) are effective for controlling seizure frequency with or without standard treatments (e.g., anti-seizure drugs)?  (JLA PSP Priority 16)
Overall ranking 16
JLA question ID 0110/16
Explanatory note Seizures may be triggered by environmental factors such as stress, lack of sleep, or poor overall health. Non-drug interventions such as aerobic exercise, yoga and mindfulness training that promote physical and mental health may reduce stress and change the level of seizure activity in the brain. However, more research is needed into the optimal type, amount, frequency and duration of lifestyle treatments and how these activities interact with standard epilepsy treatments such as anti-seizure drugs. 

Jackson, C. F., Makin, S. M., Marson, A. G., & Kerr, M. (2015). Non‐pharmacological interventions for people with epilepsy and intellectual disabilities. Cochrane Database of Systematic Reviews(9). doi:10.1002/14651858.CD005502.pub3

Panebianco, M., Sridharan, K., & Ramaratnam, S. (2017). Yoga for epilepsy. Cochrane Database of Systematic Reviews(10). doi:10.1002/14651858.CD001524.pub3

Health Research Classification System category Neurological
Extra information provided by this PSP
Original uncertainty examples Why isn't there more research into alternative methods to treat epilepsy, not just medication? ~  What lifestyle changes and regular activities (e.g. meditation, exercise, etc.) would help in reducing the chances of a seizure being triggered? ~ Can exercise and other lifestyle management techniques like eating/sleeping/mindfulness reduce seizure frequency and/or improve quality of life? ~ In my view, low impact cardiovascular exercise (biking, fast walking) contributes to the success of avoiding future seizures. Is this correct?
Submitted by People with Seizures x 26, Caregivers x 3, Friend or Family Member x 6, Health Care provider x 3, Community Agency Representative x 2, Other x 3
PSP information
PSP unique ID 0110
PSP name Epilepsy (Canada)
Total number of uncertainties identified by this PSP. 96  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 6th & 7th April 2021