Sir,We read with great interest the review article entitled “Nonpharmacological Treatment of Epilepsy” by Saxena and Nadkarni that has appeared in Ann Indian Acad Neurol.-[1] The authors reported several evidences from benefits of non-pharmacological treatment of epilepsy. They notably highlighted that therapies cited in their manuscript should not be considered as alternatives to antiepileptic medication, but as complementary therapy for epilepsy. We applaud the authors for pursuing this topic, but we are also interested in addressing some goals for this review.A large number of people with epilepsy use alternative therapies along with their conventional medicine. Although the practice of Yoga may also be referred to as exercise, programs of physical exercise (such as endurance, strength, balance and flexibility) have an important role in this picture. It is interesting to note that individuals with epilepsy and health care professionals do not usually include physical exercise programs as complementary therapy (for review see Arida et al.[2]). In accordance with this reasoning, positive effects of exercise to people with epilepsy have been increasingly reported in the literature. Studies have generally shown that physical activity can decrease seizure frequency as well as lead to improved cardiovascular and psychological health in people with epilepsy.[3-6] From an experimental point of view, beneficial actions of exercise in animals with epilepsy have been reported by our research group in the last decades. For instance, physical exercise reduced the amygdala kindling development[7] and the frequency of seizures in the pilocarpine model of epilepsy.[8] Metabolic, electrophysiological and immunohistochemical studies also demonstrated encouraging effects of exercise in rats with epilepsy.[9-11]Considering the influence of physical exercise on brain function and positive impact in seizure control, it seems reasonable to include programs of exercise as complementary and alternative medicine (CAM) in epilepsy. Epileptologists should bear in mind the therapeutic use of regular physical exercise when advising the patient to CAM. They should stimulate patients to the practice of regular physical activities not only for seizure control but also for amelioration of general health. Overall, we would like to express our congratulations to Saxena and Nadkarni[1] on their interesting paper and emphasize the possible role of exercise interference as complementary non-pharmacological treatment of epilepsy.