Transcendental meditation: A double-edged sword in epilepsy?

Transcendental Meditation (TM^®) is derived from ancient yogic teachings. Both short- and long-term physiological correlates of TM^® practice have been studied. EEG effects include increased alpha, theta, and gamma frequencies and increased coherence and synchrony. Neuronal hypersynchrony is also a cardinal feature of epilepsy, and subjective psychic symptoms, apnea, and myoclonic jerking are characteristic of both epileptic seizures and meditative states. Clinical vignettes have highlighted the potential risk of human kindling from repetitive meditation in persons practicing TM^®, but clinical studies of similar techniques suggest that meditation may also be a potential antiepileptic therapy. Future clinical studies of meditating subjects using video/EEG monitoring are warranted to determine whether behavioral phenomena have an underlying epileptic basis, and prospective clinical trials of TM^® in subjects with well-delineated epilepsy syndromes are necessary to establish the safety of this technique and its potential efficacy for seizure reduction and improvement of quality of life.