Patient 3 is a 63-year-old right-handed man, formerly a professional footballer, who was referred to our epilepsy clinic with a history of left hippocampal sclerosis, which was surgically resected 15 years earlier. Although seizure frequency decreased as a result, the patient's epilepsy remained quite refractory to treatment with four AEDs. Although some seizures would occur from sleep, the patient identified physical exertion as another clear precipitant. This was fairly reproducible, and seizure control improved dramatically when he avoided any vigorous exercise. Gentle walking was not associated with any issues. Retrospectively, the patient felt that exercise had been a part of the pattern for years, even prior to his surgery. Interestingly, in addition to his typical seizures, exercise could induce a bout of severe depressive feelings. He also found that there was a family history of depressive symptoms provoked by exercise. On review by a neuropsychiatrist, it was felt that these latter symptoms actually represented part of a postictal psychosis, and some improvement was made with the introduction of olanzapine.