Meditation may not be for epileptics

In epilepsy, a seizure begins with just a few neurons that – for reasons that still elude medical professionals –  get overstimulated. That excess stimulation then gets passed through the synapses to other neurons, which become overstimulated in turn, and the spread of that intense chaotic activity produces the behavioral features of a seizure. These disruptive bursts of activity also damage the brain, and can lead to cognitive deficits, so anyone with epilepsy will take great pains to avoid seizures, by taking medications or adopting fat-rich diets – and, of course, avoiding any known epileptic triggers. This could mean no rapidly flashing TV screens (of Pokemon seizure infamy), no music (not any easy feat)….and just to be safe, perhaps no meditation.

This the theory proposed by Harinder Jaseja in a pair of theoretical paper published in Medical Hypotheses. The first, from 2005, identifies two major reasons to think that meditation could set an epileptic up for a seizure. First, meditation alters the pattern of how neurons fire, by enhancing what’s called the alpha rhythm – the distinct way our neurons fire when we are awake but relaxed, exactly as meditation would hope to achieve. Except, that pattern might veer into “hypersynchrony”, which is too many neurons firing simultaneously, which is a seizure. Second, Jaseja suggests that meditation might increase the production of the neurotransmitters glutamate and serotonin, which have also been linked to seizures. (Concerns about glutamate triggering seizures have lead to the suggestion that people with epilepsy should avoid MSG – full name, mono sodium glutamate).

A year later, Jaseja published again, elaborating on some of these ideas. The mechanisms behind the potential links of glutamate and serotonin are explained in slightly more detail, to better connect the dots between why and how they might be enhanced by meditation and might contribute to seizures. The details are best left for the neuroscientists to ponder, but I must admit the fact that post-meditation urine containers more traces of serotonin is going to be very much on my mind the next time the urge to pee strikes during meditation. In terms of evaluation the meditation-epilepsy hypothesis, though, the most compelling new evidence was a reference to an 1993 study  suggesting that people who meditate experience symptoms also linked with epilepsy, from phantom vibrations and mild auditory hallucinations to what we might otherwise just call are a more religious experience or spiritual awareness of the world. While this study is old (that is, old in the science of the brain and the new boom of contemplative science), it is also in line with more recent research showing visual hallucinations arising from meditation.

Based on this pair of articles, it seems entirely plausible to think that reducing the usual external stimulation by focusing only on one object might let those seizure-prone neurons get all fired up. Certainly, the evidence is reasonable enough that it shouldn’t be dismissed out of hand, and the potential mechanisms mentioned are specific enough to allow for several possible studies to test the theory more deliberately.

And then….nothing. Or at least, very little. Any link between meditation and epilepsy seems to have fallen off the radar, whether it is as a risk or a treatment. Jaseja has produced one more brief theoretical piece arguing that any claims that meditation helps epilepsy should be evaluated carefully as potential placebo effects stemming from the patients’ expectations of a stress-reducing practice, but no one else seems to have anything to say on the issue. The closest I could find was one study testing whether yoga (which shares some features with meditation, but is also unique) could help treat epilepsy, but otherwise all interest in meditation-related practices and epilepsy seems to have vanished as of 2006. It could be that the population needed for any studies (people who have seizures) is too small, it could be that directly testing something that might trigger a seizure doesn’t pass ethical muster, it could be that there are other steps that need to be taken before investigating alpha waves and serotonin byproducts more thoroughly. I would hate to think that it’s just not fundable or publishable to suggest that meditation could be a harm, not just a help, for some populations.

ResearchBlogging.org Jaseja H (2005). Meditation may predispose to epilepsy: An insight into the alteration in brain environment induced by meditation. Medical Hypotheses, 64 (3), 464-467. PMID: 15617849
Jaseja H (2006). Meditation potentially capable of increasing susceptibility to epilepsy – A follow-up hypothesis. Medical Hypotheses, 66 (5), 925-928. PMID: 16434149

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6 thoughts on “Meditation may not be for epileptics

  1. Very interesting post.
    However the quality of speculation of Jaseja as to the potential link between meditation and epilepsy is quite low. There aren’t even any correlations, let alone suggestions of causality. Jaseja based his ideas entirely on mere associations.
    Of course, it would be interesting to test the hypothesis, but I wonder – if Jaseja’s idea is so strongly supported by the data, why haven’t we seen any studies? I doubt that ethics committees would block such studies.
    In your post you write about “evidence”, yet we have yet to see any.

    • I agree that evidence would be preferable to just theory and inference – but I do think theory and inference are a good place to start. That’s especially true when the topic has even the risk of ethics committee disapproval. I’ve found ethics committees to be rather stringent. I know that some researchers have successfully replicated Milgram’s work with ethics committee approval, but I also recently attended a presentation about what factors really predict first-year student success that reportedly took double-digit attempts to get through an ethics committee, and I had a heck of a time getting approval for a student project using a standard depression questionnaire for children. Any attempts to convince the committee that the risks of a seizure were low would simultaneously be arguments that the research didn’t really have a good chance of success. I’m sure there’s a way to get one approved, but it takes a lot of conviction (and probably the security of tenure) to be willing to go through the process.

      • Thanks for the reply.

        I’m not sure why are you using the term “theory” in respect to the ideas presented in the cited papers. Even the author of the papers seems to be identifying his idea as a hypothesis.

        Regarding comments on ethics committees — the need for an empirical test of the hypothesis is even stronger. Ethics committees should not be influenced by mere associations and untested assertions.

        What is especially puzzling is the fact that the author has written at least three articles on the topic, none of which presents anything resembling evidence. 10 years after the publication of the first paper no one was able to corroborate the statements. I think that the lack of empirical research on the topic may be due to the unwillingness of journals to publish null findings. No effect (in this case: no correlation between meditation practice and frequency of epileptic episodes) may translate to no publication. You can read about the publication biases here:
        http://www.nature.com/news/social-sciences-suffer-from-severe-publication-bias-1.15787
        http://news.sciencemag.org/math/2014/08/why-null-results-rarely-see-light-day

        Of course, I’m not asserting that this is indeed the case. However the lack of any empirical reports on the matter a decade later makes me highly skeptical about the matter.

      • I am guilty of blurring the formal distinction between “theory” and “hypothesis” when I am not teaching students the scientific method, and particularly on this blog, where I try to keep in mind a broader audience than strict scientists. In this case, I meant it simply as an acknowledgement that the idea is purely theoretical, not tested by specific evidence.

        When I was in grad school, we had a running joke about our desire for a “Journal of Null Results”, where people who had carefully designed a study with appropriate statistical power could submit studies that had not found statistical results. That was prompted by our lab’s ongoing failure to replicate a particular published study, some three years in. Lacking such a journal, we have no idea whether the research was ever done, whether Jaseja sees it more as an interesting thought experiment instead of a fruitful line of possible research, or what features of the design might have rendered the results too questionable to publish. It’s one of the most frustrating aspects of research that we rarely know what’s been done unsuccessfully.

      • Yes, you are guilty :) I think it is not any less important to mark the distinction between the understanding of scientific theories and the colloquial phrases “in theory” and “theoretically”. If we forsake doing this, we are sure to read more “it’s just a theory” stuff.

        Indeed, such attempts at cataloging null results are present, for example:
        http://www.jasnh.com/
        http://www.psychfiledrawer.org/

        Recently a post publication review format of papers publication has started to appear. In this way, people have access to comments and reviews of papers that are available even after the article passed peer review process. Take a look at:
        http://www.ncbi.nlm.nih.gov/pubmedcommons/
        There surely are similar places on the Internet.

        I really like your blog. I’ve been visiting for the past few months. Keep it up!

  2. I can tell you as a patient with confirmed post traumatic epilepsy who is/was an avid meditator before and after my accident that deep meditation has induced seizure activity. Different seizures that are frontal lobe vs temporal lobe seizures that I hadn’t experienced before outside of meditation. There needs to be more research done on this as it was quite scary for me.

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