Heath Notes

Epilepsy

Also indexed as: Convulsions, Falling Sickness, Seizure Disorders

A sudden seizure is the most clear and common sign of this brain disorder. According to research or other evidence, the following self-care steps may help you manage epileptic episodes:

Get some extra E
Improve treatment results in children by supplementing with 400 IU of vitamin E a day

Check out Chinese herbal formulas
Try 2.5 grams a day of sho-saiko-to or saiko-keishi-to in tea or capsules

Consider a Ketogenic diet
To help reduce seizures in children, consult a specialist trained in initiating and supervising this special diet

Uncover food sensitivities
Work with a knowledgeable professional to find out if eliminating certain foods reduces seizure frequency

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full epilepsy article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About epilepsy

Epilepsy is a brain disorder in which abnormal bursts of electrical activity occur in cells of the brain, resulting in seizures.

There are many types of epilepsy, usually categorized by the symptoms that occur during seizures. The cause of many types of epilepsy is unknown, and frequently no cure is available. Rather, treatment focuses on reducing the frequency and severity of seizures.

Product ratings for epilepsy

Science Ratings	Nutritional Supplements	Herbs
	Vitamin E (for children)
	EPA and DHA	Bupleurum in combination with peony root, pinellia root, cassia bark, ginger root, jujube fruit, Asian ginseng root, Asian scullcap root, and licorice root
	Folic acid Melatonin Taurine Vitamin B6 Vitamin E (for adults)	Bacopa
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms?

There are many types of seizures in epilepsy. They are categorized as either partial or generalized, depending on how much of the brain is involved. Some types of epilepsy involve seizures characterized by convulsive muscle contractions of all or some parts of the body. Other types can involve momentary loss of consciousness, amnesia, unusual sensations or emotions, and other symptoms. Symptoms that indicate an imminent seizure (called auras) may occur. Similarly, non-convulsive symptoms, including deep sleep, headache, confusion, and muscle soreness (called a postictal state), may follow a generalized seizure.

Dietary changes that may be helpful

The ketogenic diet was developed in the early twentieth century when few drug treatments for epilepsy were available; until recently, it had been used only when drug therapy was ineffective. The dietary approach was based on the observation that ketosis (increased blood levels of chemicals called ketones) is associated with reduction of seizures.¹ Ketosis can be produced by a diet high in fat and very low in carbohydrate and protein. The ketogenic diet has been evaluated in several preliminary and a few controlled trials. According to a 1996 review, the ketogenic diet appears to be very effective in one-third to one-half of epilepsy cases in children, and partially effective in another one-third of cases.²

Recent trials continue to support this success rate;³ ⁴ ⁵ one preliminary trial demonstrated a 50% reduction in seizure activity in 71% of children in a group after 45 days on the diet. There is little research on the effects of the ketogenic diet in adults, but it may be effective in those who are able to comply with the strict dietary guidelines.⁶ ⁷ The diet is usually initiated by fasting under close medical supervision, often in a hospital, followed by introduction of the diet and training of the family to ensure successful maintenance.

Possible side effects of the ketogenic diet include gastrointestinal upset, dehydration, anemia, low blood protein levels, high blood levels of fat and acidity, kidney stones, and signs of liver toxicity.⁸ ⁹ Vitamin and mineral supplementation is necessary due to the many deficiencies of this unusual diet.¹⁰ The ketogenic diet should not be attempted without the supervision of a qualified healthcare professional. Practical information about the ketogenic diet is available in recent texts ¹¹ and articles,¹² as well as on the Internet.¹³

The Atkins diet is similar to the ketogenic diet, in that they are both high in fat and very low in carbohydrate. The Atkins diet, however, is easier to follow than the ketogenic diet, as it allows more liberal amounts of protein and has fewer calorie restrictions. Since the Atkins diet can produce ketosis, it has the potential to benefit people with epilepsy. In a preliminary study, three of six individuals with treatment-resistant epilepsy experienced marked improvement on the Atkins diet; two of these people became seizure-free.¹⁴

Allergic reactions to food have been reported to trigger epileptic seizures in individual cases,¹⁵ ¹⁶ some of which were proven with double-blind testing.¹⁷ One report found people with epilepsy to have significantly more biochemical evidence of allergy than do non-epileptics.¹⁸ A study of children who suffered from both epilepsy and migraine headaches found that a diet low in potential food allergens reduced seizures in the majority of cases; however, children who had epilepsy alone without migraines did not respond to the diet.¹⁹ Another report confirmed that children who have epilepsy without migraines do not improve on a low-allergen diet.²⁰ Some doctors recommend that people with epilepsy and other allergic symptoms, such as asthma or hay fever, should be checked for food allergies that may be causing seizures.²¹

Other therapies

About 10 to 20% of epilepsy patients do not respond to drug therapy and may require surgery.

Vitamins that may be helpful

Vitamin E has been studied as a possible add-on to conventional drug treatment for epilepsy. A double-blind trial found that adding 400 IU per day of vitamin E reduced seizure frequency in children without side effects.²² Other preliminary trials²³ ²⁴ have reported similar results, and, while some preliminary research suggested this effect might also be achieved in adults,²⁵ a double-blind trial found no effect of vitamin E supplementation on adults with epilepsy.²⁶

Folic acid supplementation (5 mg per day) was reported to reduce epileptic seizure frequency, though the effect was not significantly better than with placebo.²⁷ Folic acid supplementation of as little as 800 mcg per day has also been reported to interfere with the action of anticonvulsant medications, resulting in an increase in the frequency and/or severity of seizures;²⁸ ²⁹ ³⁰ ³¹ this effect occurs only in a small number of cases.³² ³³ People taking anticonvulsant medications should consult with the prescribing physician before deciding whether to use folic acid.

Vitamin B6 has been used to treat infants and small children who have seizures related to a genetic enzyme defect.³⁴ ³⁵ ³⁶ ³⁷ However, this condition is not considered true epilepsy, and whether people with epilepsy would benefit from taking vitamin B6 supplements is unknown.

Taurine is an amino acid that is thought to play a role in the electrical activity of the brain; deficits of taurine in the brain have been associated with some types of epilepsy. However, while some short-term studies have suggested that taurine supplementation may reduce epileptic seizures in some people, the effect appears to be only temporary.³⁸

Case reports have suggested that evening primrose oil may worsen symptoms in people with temporal lobe epilepsy.³⁹ Until more is known, people with this type of epilepsy should avoid using evening primrose oil supplements, except perhaps under the supervision of a qualified physician.

In a preliminary study, supplementation with 3.25 grams per day of a mixture of omega-3 fatty acids (primarily eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) for six months markedly reduced the frequency of seizures in five severely retarded epileptic patients.⁴⁰ Additional research is needed to confirm this report and to identify which people with epilepsy are most likely to benefit.

A small, preliminary trial found that 5 to 10 mg per day of melatonin improved sleep and provided “clear improvement of the seizure situation” among children with one of two rare seizure disorders.⁴¹ More research is needed to determine whether or not melatonin could benefit other people with epilepsy.

Two elderly individuals with well-controlled epilepsy reportedly developed recurrent seizures within two weeks of starting Ginkgo biloba extract.⁴² Individuals with epilepsy should not, therefore, take Ginkgo biloba without medical supervision.

Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful

The Chinese herb bupleurum is included in two similar Chinese herbal formulae known as sho-saiko-to and saiko-keishi-to; these combinations contain the same herbs but in different proportions. The other ingredients are peony root, pinellia root, cassia bark, ginger root, jujube fruit, Asian ginseng root, Asian scullcap root, and licorice root. Both formulas have been shown in preliminary trials to be helpful for people with epilepsy.⁴³ ⁴⁴ ⁴⁵ No negative interactions with a variety of anticonvulsant drugs were noted in these trials. The usual amount taken of these formulas is 2.5 grams three times per day as capsules or tea. People with epilepsy should not use either formula without first consulting with a healthcare professional.

One older preliminary trial in India found an extract of bacopa, an Ayurvedic herb, reduced the frequency of epileptic seizures in a small group of people.⁴⁶ However, another similar preliminary trial gave inconclusive results.⁴⁷ Controlled research is needed to properly evaluate whether bacopa is helpful for epilepsy.

Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.

References
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13. http://www-leland.stanford.edu/group/ketodiet

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2009.

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