Many people with epilepsy use complementary and alternative medical products, but some of those items may conflict with traditional epilepsy treatments. Also, these products aren't necessarily proven remedies and may have unwanted side effects.
To be on the safe side, patients are encouraged to tell their doctors about any products they're taking. But a recent survey of 187 people with epilepsy (or their caregivers) showed that more than half (56%) reported using some sort of complementary or alternative medical product, while only 68% of those patients had let their doctors know about it.
Almost 14% of complementary and alternative users took products containing ingredients that had the potential to increase seizure occurrence. Those ingredients include ephedra, ginseng, evening primrose, and ginkgo, the researchers report. In addition, almost a fifth of complementary and alternative medicine users took products that could interfere with the metabolism of their epilepsy medication. St. John's wort, echinacea, and garlic might affect liver enzymes that influence the body's response to medicine.
However, there are some alternative epilepsy treatments where medical/clinical studies have been published. You should research any epilepsy treatments you are considering thoroughly and discuss them with your doctor before trying them.
EEG Neurofeedback
EEG Neurofeedback is a specific form of biofeedback. It involves an apparatus to measure some biometric data and provide the subject with some feedback on the data. In classic biofeedback, heartrate/pulse or breathing are usually measured. In neurofeedback, EEG impulses are measured. The EEG impulses are monitored by a computer which analyzes the brain wave patterns within a couple of defined spectrums commonly called alpha, beta, theta, delta and gamma.
A fair number of controlled clinical studies have produced consistent data on the efficacy of SMR training in epileptic patients. It is particularly noteworthy that these results have been achieved in an extremely difficult subgroup of epilepsy patients, those with poorly controlled seizures who had proven unresponsive to pharmacological treatment. In reviewing the data accumulated in these studies, researchers found that 82% of 174 participating patients who were otherwise not controlled had shown significantly improved seizure control (defined as a minimum of 50% reduction in seizure incidence), with around 5% of these cases reporting a complete lack of seizures for up to 1 year subsequent to training cessation.
For most conditions, there are no known adverse side effects of the training, provided that it is conducted under professional guidance.
Neurobehavioral / Cognitive Behavioral Therapy (CBT)
This approach sees epilepsy as a behavioral disorder with functional symptoms. The seizures are triggered by emotional reactions and stressful situations. The seizures are not caused by damage to the brain, rather the damage has lowered the threshold at which the brain can no longer handle or recover from an overload on its circuitry. When the overload threshold is passed, a seizure occurs. In some cases it may take weeks or even months to reach the threshold, in others as little as 30 seconds. Instead of shutting down brain functioning through drug therapy to prevent seizures, a self-discovery process is implemented relating the personal responsibility of the individual to the occurrence of their seizures. It minimizes or eliminates drug therapy, and reestablishes personal dignity by allowing the individual to achieve a normal and productive life.
According to researchers, total seizure control was achieved by 35 out of 44 patients in two groups seperated by right and left hemisphere, or 79.5% for the total population treated in the brief therapy model. Those patients identified as having achieved control had been seizure-free for 6 months or longer. Both groups showed a significant reduction in seizure frequency following treatment. The proportional reduction in seizures was calculated for each patient, this proportion was converted to a percentage, and then computed as the mean per cent for each group of patients. The mean per cent of reduction of seizures in both groups is greater than 90%. The mean for the left-hemisphere group is 95.7% and the mean of the right-hemisphere group is 93.7%.
There are no known adverse events. This therapy does not involve any invasive or unnatural processes.
Diet
Several types of specialized diets have been shown to have positive effects in reducing seizure frequency in epileptic patients.
The ketogenic diet is a high fat, low carbohydrate, low protein diet that has been used since the 1920s for the treatment of epilepsy. In the ketogenic diet the body's energy source comes from using fats instead of glucose. Ketones are made when the body uses fat as its source of energy. This is called 'ketosis'. For some people with epilepsy, when their body makes ketones it helps prevent seizures from happening.
The ketogenic diet is only believed to help improve seizure control in children. It may not work for every child and it is not possible to predict who the diet will help.
The diet must only be followed with the support of an experienced paediatrician (children's doctor) and dietician (food specialist). It can be adapted to all ethnic diets and is suitable for children who are allergic to dairy products. However when dairy foods are left out it can be more difficult to follow the ketogenic diet as it limits the food choice.
The modified Atkins diet is a modification of the traditional ketogenic diet that had been used for several years by families mostly who had been using the ketogenic diet for many years and eventually stopped weighing and measuring foods. They had noticed ketones still remained high and seizures under control.
Although the foods are very similar, there are key differences between the modified Atkins diet and the ketogenic diet. First, with the Atkins diet there is no fluid or calorie restriction. Also, although fats are strongly encouraged, there are no restrictions on proteins. In addition, foods are not weighed and measured, but carbohydrate counts are monitored by patients and parents. It is started outside of the hospital, without a fast, as well. Lastly, foods can be eaten more freely in restaurants and outside the home. The diet is a "modified" Atkins diet as it allows for less carbohydrates than traditional Atkins (10-20g/day) and more strongly encourages fat intake.
Preliminary results in a small number of patients suggests that the modified Atkins diet may help some children with intractable seizures.
You should talk with your neurologist and dietitian about how to start the diet and if it's the right decision. Once you do, lab work is usually obtained, and ketone strips are prescribed. Carbohydrates are limited and the foods change overnight (hard to transition).
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