Part 1
Epilepsy from the Greek word epilepsía is a neurological disorder that causes recurring seizures, which vary in intensity and symptomatic range. The Ayurvedic term for epilepsy is Apasmara, a vata (wind) condition whereby seizures occur when there is abnormal neural oscillation, giving rise to sudden bursts of electrical activity in the brain. This interference prevents brain cells from communicating normally, blocking or misfiring signals. This often results in loss of consciousness. Such occurrence affects the nervous system dramatically. The mind and emotions are triggered and motor and sensory stimulation causes the body to move or convulse and receive awareness altered information that disconnects the individual from normal states of being. Epilepsy affects both children and adults, (usually over 65 years of age) with half a million people in the UK and fifty million worldwide, where two out of three cases occur in developing countries. There are over forty varieties of epilepsy, all with unique combinations of seizure type, prognosis and treatment. There are also many seizure types, which depend on area, speed and range of movement throughout the brain, all affecting the body in a specific way. Seizures are controlled with medication where possible and sometimes surgery takes place to facilitate relief. Epilepsy is considered as a syndrome, which means it has a broad range of symptoms all including abnormal neuro-electrical activity.
Causes of Epilepsy
In many cases the exact cause of Epilepsy is unknown and in some the most common are:- head injuries that cause brain damage, birth traumas, high fever and being shaken or manhandled, due to large amounts of certain medicines, alcohol, drugs, exposure to toxic waste, tumour or stroke whereby the blood supply to the brain is interrupted, the effects of brain surgery, cardiovascular problems, diseases altering the blood or damaging nerve cells in the brain, or low resistance to seizure known as low threshold. It is also possible, although rarer, to inherit the condition which is known as ‘symptomatic’ (arising from a lesion or metabolic defect) due to the above causes. The two other strains of epilepsy are ‘idiopathic’ (genetic and arising from general abnormality which alters neuronal regulation) or Cryptogenic, where the lesion is nearly or totally unfathomable. Epilepsy is not contagious although it can be caused by a virus. Some epilepsies require ‘triggers’, such as flashing lights, reading and loud or monotonous noise. These are known as Reflex Epilepsy. Precipitants occur too where for example a child will experience hyperventilation, which can also act as a trigger for a seizure. As well as this, stress, missing meal or medicine time, sleep deprivation, high temperature, alcohol, drugs and hormonal shifts, are also examples of seizure facilitators.
Symptoms
There are a broad range of symptoms accompanying Epilepsy which include partial or general seizures, relative to which areas of the brain are affected. In a partial seizure one remains conscious and will experience one or more of these symptoms:- joy or fear, strange tastes or smells, déjà vu, pins and needles or numbness, twitching and jerking in isolated regions, flashing or coloured lights and hallucinations. One may also have a complex partial seizure in which a larger area of the brain is affected. This frequently prolongs a seizure, entails chewing and/or lip smacking, repetitive and confused movement, thrashing of the limbs and mumbling or gibberish. It may lead to partial consciousness and often loss of any memory of the event. A general seizure affecting a large proportion of the entirety of the brain leads to loss of consciousness and memory recall after the event. General seizures occur in a few ways. A Tonic-Clonic which is the most common type, where in the tonic phase there may be crying out, loss of balance, colour, bladder and bowel control, stiff muscles, confusion and blacking out. A Clonic seizure is where one convulses at the onset of a seizure yet the body doesn’t stiffen. Before a seizure there is usually an ‘aura’ (such as a taste in the mouth) which warns the person that they are about to have a seizure. Following a seizure it is common to have a headache and feel very tired. There are other type of seizure such as atonic, myoclonic, absence, nocturnal and secondary generalised, all of which include aspects of the above mentioned causes and symptoms.
Treatment
Epilepsy is managed by employing Anti Epileptic/Convulsant Drugs which help to prevent seizures in about 80% of people with epilepsy. It is of course possible for patients to gradually reduce and even cease medication in some cases. Surgery is sometimes carried out to stimulate the vagus nerve which reduces the intensity and frequency of seizures and neurosurgery is occasionally used to treat the brain where a surgeon feels this is the most direct option to relieve and possibly cure symptoms. Others try the ketogenic diet, which is a high fat, low carbohydrate, controlled protein diet, allowing the body to use fats as its energy source.
How Yoga Helps
Sickness arises due to imbalances of energy within the various layers and systems of our being. Yoga restores this balance, by allowing us to listen to the inners aspects affected. It does so by slowing and stilling the awareness to levels previously unchartered, so that we may see and therefore know how to calm that which is overactive and stimulate that which is under. Like sleep, the rest that yoga proffers enables the deepest renewal of the parts we know are susceptible and open to change; the mind and body.
Although medicines are used necessarily to help someone with epilepsy, yoga practice creates stability due to the fusion of the faculties of breath, mind, senses and body, which simultaneously remove one from the impermanence of bodily existence (by allowing contact with absolute awareness which is beyond all of these) and in other moments, grounds you to accept and embrace yourself fully, so that all the circumstantial colour of life’s tapestry dance with the light of a classic Renoir, Yoga helps us to stop worrying about what others think. Our conscience tells us what is intrinsically right or wrong. For some the relief given by yoga is mild and for others, nothing short of miraculous.
Asanas regulate pressure in the central nervous system, myofascia and internal organs, so that metabolic stability restores calm as well as improves circulation, respiration and absorption, all of which reduce the risks of seizure. Meditation improves the circulation of prana and therefore blood to the brain. It increases the production of serotonin so that well being is experienced and communicated throughout all layers of being. This reduces stress, (possibly the cause of all illness), due to its effects upon the psyche and immunity. To experience such deep happiness allows the mind to trust in letting the restorative nervous system function optimally, which entails hard and soft wired pathways of the brain being upgraded to include or delete information transmission.
Yogis have known for eons that to control the breath is a means to control the mind and consciousness. The cure for epilepsy lies in regulating cerebral activity. This may only be theoretical for some, while for others a reduction or cessation of seizures has become reality. Yoga practice is ever renewing so that no matter how much we feel we can’t face the slings and arrows with which we are tested, joy arises out of the emptiness every moment. This breathes into us the courage to face and understand the meaning of life; observing, accepting, managing and transcending aspects of the impermanent self (body and mind), in order to glimpse and revel in the inner joy or permanence of the soul.
Copyright Matt Gluck 19th July 2011. For more information about Pranasana Yoga, Relaxation and Breathing Techniques please visit www.pranasanayoga.com or email [email protected].
Part 2
Last month we looked at the causes, symptoms and current treatment of epilepsy with an outline of how yoga helps improve life with this condition. To do so and possibly even cure epilepsy, the answers lie within understanding and possibly regulating activity within the brain. To this end, yoga may be of immense benefit. One of the greatest discoveries of the ancient seers was that the ‘stuff’ which fuels both physical elements such as the cerebrum and their energetic counterparts, the mind and higher intellect, all share a common yarn. Consciousness enlivens everything and as it permeates the universe it takes on varying forms, such as magnetic or electric energy. What the sages realised was that this energy or prana, which is carried as an electrical current through the air and is drawn in through the breath, contributes to forming the mind-body-stuff in a similar yet more sublime way than solid or liquid food. In simple terms this means we can use breathing techniques to help regulate the mind and central nervous system, triggering responses which tend towards relaxation or stimulation. In the case of epilepsy where there is neurological suppression and/or confusion, pranayama breathing techniques combined with asanas and meditation can be applied to improve circulation and instil calm, both reducing the risks of seizure. Depending upon the individual and their threshold to seizures, yoga may help to reduce their frequency and intensity and/or provide tools that empower one to deal with its stresses before and after a seizure. What yoga teaches is that although the symptoms on an illness may persist even after years of practice, suffering can cease due to our evolving inner relationship and personal definition of a cure.
Asanas
- Before practicing postures, do some joint mobilising exercises to stimulate the smooth flow of chi in the body prior to more weight bearing exercises. Neck and shoulder exercises are extremely relaxing and trigger a sense of immediate self awareness. They open the lungs and gain access to the spine or axis which we manipulate to acquire balance in the spinal cord and brain. Then rotate the ankles and wrists and hips in any order that resonates with you. Be aware of your breath.
- Perform a standing or seated pelvic tilt (cat pose) so that the spine moves through full linear flexion and extension. If you are standing, breathe when you tuck your chin and tail in (forward bend) bring your elbows together and breathe again when you open your chest and tilt the back of the hips upward to the rear (backward bend) opening your arms to the sides, expanding your chest and looking up comfortably. These movements will stimulate the nerve plexuses along the spinal cord, where smooth movement will encourage a regulation and balanced distribution of nerve energy throughout this ‘electric cable’.
- Practice standing and seated forward bends (uttanasana, paschimottanasana and janu sirsasana) to calm the mind and nerves, observing how the application of conscious regular abdominal breathing aligns you with your spirit.
- Practice inversions to further relax the mind and rejuvenate the brain with oxygen. In the long term, by promoting conscious relaxation, this positively affects the unconscious mind and pathways which trigger seizures. As well as this the inversions trigger the vagus nerve (see pranayama below).
Good asanas are the rabbit, plough, shoulder stand and headstand, depending upon your body, its history in physical exercise and experience in yoga practice. You will find that having selected the appropriate postures for your level, you will feel deeply relaxed and centred afterwards. It is important not to attempt challenging postures that leaving you feeling weak and shaky, but to ascertain which ones you can practice regularly in order to establish a safe, effective and long term perspective. - Reclining postures such as Setu Bandhasana (bridge) and Viparita Karani (legs up the wall) are both excellent. The first as it opens the heart, airways and tension in the belly, improves immunity and helps us to feel alive! Viparita Karani is where you lie on your back with your legs up the wall, so you can relax.
- If you also incorporate half and full Virasana, (Hero pose), with Baddha Konasana (bound angle) and combine these with reclining, bending forward to relax your upper body over your lower one and, twisting (gently) towards the knees and looking over your shoulders, you will find these all relax and open your hips and inner breathing spaces. Combine these seated positions with 1. Gomukhasan Arms (Cow Pose) 2. Eagle’s Arms and 3. Reverse Prayer Position - all to open your chest, shoulders and upper body.
If you wish to perform the inversion poses at the end of this sequence that’s fine. Experiment with the order to see which suits you the best. As you become familiar with sequencing you will be able to adapt the order intuitively each time you practice.
- Follow this with a few seated side stretches and twists to either side, breathing vocally, “Hhhaaaaaaa”, deeply in to your belly and ribcage and you will feel ready to do some breathing practices, meditation or finish here and relax totally.
A practice like this will help to keep your body soft and strong which will help it to meet the stresses placed upon it by seizures, medication and their many possible side effects. It is essential to remain aware of the breath during each asana and to observe it’s patterns as they change throughout any sequence. This creates integrity and leads to concentrated awareness.
Pranayama
Although rapid breathing techniques are used in clinical studies to trigger epileptic seizure, we are not going to recommend any here. It is however interesting to note that as with snake venom, which contains a dose of the poison itself, one should consciously investigate the boundary between the two states of what we call ‘relaxation’ or ‘stimulation’, as mentioned while observing the subtle changes of breath during the above postures practice. Insights gained from this inquiry provide us with knowledge to help prevent triggers and circumstances which from experience, are likely to lead to ‘falling down the same pothole over and over again’.
During breathing practice we will at times move the chin towards the chest (jalandhara bandha), which will help to stimulate the vagus nerve and slow the heart. This is specifically relevant in Epilepsy as this stimulation can play a major part in reducing the intensity and frequency of seizures. Repetitive pranayama practice encourages the body to return to ‘natural breathing’, whereby the diaphragms, abdomen and intercostals muscles are all activated to maximise oxygen uptake with minimum effort and flush toxins out of the body with equal vigour. By lengthening the exhalation, the autonomic nervous system switches to its parasympathetic branch, which triggers healing and regeneration. This will in turn allow for deepened inhalation which is guided calmly down in to the centre of gravity, below and behind the navel.
Exercises
Exercise 1 – Lengthen the Exhale haaaaaa 10x
Exercise 2 – Observe the exhale pause 10x
Exercise 3 – Lengthen the Inhale pause (and retain the breath a few seconds with the chin towards the chest) so that you can control the flow of the outgoing air afterwards easily 10x. Contra Indications – not during pregnancy or with defective heart.
Exercise 4 – Balance the feeling of exhalation with inhalation.
By practicing the above regularly this will help to provide calm before and after a seizure. It may also lessen its intensity. Pranayama will develop concentration (Dharana) which is the preliminary stage to Dharana (meditation).
Concentration
Exercise
Focus on the point between the eyebrows and inhale from there to the pineal gland in the centre of the brain (above the top palate and between the ears). Exhale back to the pineal gland and repeat for about five minutes.
Exhale from the middle of the brain up to the crown point and inhale back in to the centre of the brain. Repeat a few minutes.
Exhale and inhale from the centre of the brain down in to the heart for a few minutes.
Exhale and inhale from the centre of the heart down in the lower belly, below and behind the navel, for a few minutes.
This exercise will help to align what the Taoists call the Three Dan Tiens, the brain, heart and belly. You will feel the calm and joy of subtle spiritual energy fusing into your being and pouring down in to your abdomen, where you can assimilate and store it.
Meditation
Dhyana (meditation) will naturally grow out of dharana practice. Meditation is the letting go of the habitual mind, to the empty mind and ocean of possibilities. The ability to empty the mind of its habitual attachments and aversions, which unfolds due to persistent practice, enables the brain and body to rest and reorganise themselves. Meditation can take place sitting or lying if this is preferred, although the latter is more prone to inducing sleep. Good meditation practice will enhance the production and circulation of neurotransmitters, such as serotonin and dopamine, upon which the body relies to function. The net effect is increased well being and a true sense of perspective. Meditation practice teaches us how to be present to ourselves and therefore remain in the present. For definitive support with seizure control, meditating regularly will provide inner guidance as to how to live more easily with a condition like Epilepsy.
Yoga Nidra
Practice seated or reclining relaxation, which will also develop concentration and may lead to deep states of meditation. Feeling the weight of the body and observing the body parts as awareness presents them to you, or moving through the body systematically, will relax the mind and body deeply. Listening to a vocal breath (mouth closed and ehxhale/inhale with a haaaaa) will help you to stay focused and alert.
Massage – Try to massage your face, forehead, scalp, hands and feet every so often to further aid relaxation.
Copyright Matt Gluck 7th September 2011. For more information about Pranasana Yoga, Relaxation and Breathing Techniques please visit www.pranasanayoga.com or email [email protected].