Shadowboxing-induced reflex seizures in a patient with focal epilepsy

Toshiki Okadome, Hajime Takeuchi, Takahiro Yamaguchi, Takahiko Mukaino, Hidenori Ogata, Katsuhisa Masaki, Hiroshi Shigeto, Noriko Isobe

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Exercise-induced reflex seizures are a rare form of reflex seizures that are exclusively induced by a specific type of exercise. Many patients with exercise-induced reflex seizures exhibit drug-resistance, and are therefore advised to avoid the triggering exercise. Here, we describe a focal epilepsy patient with shadowboxing-induced reflex seizures. His semiology included focal aware seizures with speech and behavioral arrest that evolved to head version to the right, preceded by cephalic aura. We identified a specific motion that induced these seizures during shadowboxing using video-electroencephalographic recording, and the patient was able to continue boxing by avoiding this motion. We speculate that a broad brain network may be the pathological substrate of his exercise-induced reflex seizures. Identification of the specific motion that induces exercise-induced reflex seizures is useful for not only understanding the underlying pathophysiology, but also for minimizing the therapeutic restriction of the exercise.

Original languageEnglish
Article number100543
JournalEpilepsy and Behavior Reports
Publication statusPublished - Jan 2022

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience


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