Yoga in Epilepsy Management: A Systematic and Narrative-Integrative Review of Clinical Outcomes and Neurophysiological Mechanisms

Abstract

Epilepsy is a chronic neurological disorder characterised by recurrent unprovoked seizures and a considerable psychosocial burden. Anti-seizure medications remain the cornerstone of treatment; however, approximately one-third of patients develop drug-resistant epilepsy or experience adverse effects that compromise adherence and quality of life. These clinical limitations have increased interest in complementary approaches, of which yoga has received particular attention. This systematic and narrative-integrative review synthesizes evidence on yoga-based interventions in people with epilepsy, focusing on clinical outcomes, neurophysiological mechanisms, and methodological quality. A PRISMA 2020-aligned search of major biomedical databases identified relevant studies published between 1980 and 2025. Clinical trials and mechanistic studies evaluating seizure frequency, electroencephalographic parameters, autonomic function, stress biomarkers, psychological health, and quality of life were included. The review of 45 included studies indicates that yoga may provide adjunctive benefits in seizure reduction, autonomic stabilisation, stress modulation, and emotional well-being. Proposed mechanisms include enhancement of parasympathetic activity, attenuation of hypothalamic-pituitary-adrenal axis dysregulation, and modulation of inhibitory neurotransmission. Heterogeneity in study design, small sample sizes, and variable intervention protocols limit the generalisability of current findings. Overall, yoga appears to be a safe adjunctive therapy with potential multidimensional benefits in epilepsy management. Larger, rigorously designed randomised controlled trials are required to establish definitive efficacy and to inform clinical integration.