Three children with epileptic seizures occurring during exercise are reported from the Section of Electroencephalography and Pediatric Neurology, Mayo Clinic, Rochester, MN. Epileptiform paroxysms were noted with exercise but not with hyperventilation during EEG recordings in these patients. The pathophysiologic mechanism was unclear. 
COMMENT. A cardiac pathogenesis is usually suspected when seizures occur during physical exercise, as noted by the authors. A full cardiac examination including EKG and echocardiogram is advisable in patients with seizures occurring during physical exertion, even in children. Exercise is an unusual precipitant of seizures and is generally accompanied by a reduction in EEG seizure discharges. A clinical seizure was not induced but a spike and wave discharge occurred in each of these three patients after 5, 71/2 and 27 minutes of pedaling a stationary bicycle.