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Yoga for epilepsy


Clinical bottom line:

Evidence from a single small trial suggests that Sahaja yoga reduces the frequency and duration of seizures in individuals with epilepsy. Only 22 patients were assessed and robust conclusions cannot be drawn.

Yoga involves breathing exercises, posture control, devotional sessions and meditation. It is considered to reduce stress and induce relaxation. This may help sufferers of epilepsy since stress is thought to be an important precipitating factor.

Systematic review

Ramaratnam S, Sridharan K. Yoga for epilepsy (Cochrane Review). In: The Cochrane Library, Issue 1, 2001. Oxford: Update Software.

Date review completed : November 1999

Number of trials included : One

Number of patients : Total 32

Control group : Sham yoga movements or no intervention

Main outcomes : Number of patients seizure free, reduction in seizure frequency, at least 50% reduction in seizure duration after six months

Inclusion criteria were randomised controlled trials which assessed yoga for the treatment of epilepsy.

MEDLINE, the Cochrane Library, Cochrane Epilepsy trials group register, Yoga Biomedical Trust and research Council of Complimentary Medicine were searched. Various relevant institutions and authors were contacted for additional information.

Findings

One trial assessed patients with uncontrolled epilepsy (more than four seizures in the three months before randomisation) to either Sahaja yoga (10 patients), sham Sahaja yoga (12) or no intervention (10) over six months. The mean age of patients ranged between 20-25 years and the mean duration of illness ranged between 4.2-7.3 years. Patients who received no intervention were younger and had a shorter history of epilepsy than those in the other groups. Patients in all groups continued their antiepileptic medication.

With Sahaja yoga 4/10 patients were seizure free during the six month treatment period, but no patients in either control group (0/10, 0/12) were seizure free. The odds ratio was 14 (95% confidence interval 0.7 to 317) for Sahaja yoga compared with sham yoga technique, and 17 (0.8 to 373) for Sahaja yoga compared with no intervention.

The mean numbers of seizures per month for patients randomised to Sahaja yoga, sham yoga and no intervention were 3.2 (standard deviation 1.9), 3.0 (2.2) and 1.7 (1.0) respectively at baseline. After six months of treatment they were 0.5 (standard deviation 0.6), 2.6 (1.6) and 1.6 (1.0) respectively. The weighted mean difference was 2.1 (95% confidence interval -3.1 to -1.0) for yoga versus sham yoga, and -1.1 (-1.8 to -0.4) for yoga versus no intervention.

Nine out of ten patients had at least 50% reduction in the frequency of seizures with yoga compared with 1/10 with sham yoga and 0/12 with no intervention; odds ratios were 81 (4.4 to 1504) and 158 (5.8 to 4336) respectively.

More than 50% reduction in seizure duration after six months of treatment occurred in 7/10 patients with yoga and 0/22 with the control interventions.

Adverse effects

Not mentioned.

Comment

This single small trial showed modest benefits of Sahaja yoga over sham yoga and no intervention. Sample size is important because single small trials are unlikely to overcome the effects of chance; their results are likely to be misleading. Larger studies would be more informative.

Identifier 7970 YOGA FOR EPILSPSY: Apr-2001