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Holistic therapies for epilepsy

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My friend’s 11-year-old daughter has epilepsy and still has seizures even though she is taking medication. She is trying to find out about effective holistic therapies for her. Can you help?

S.P., via email

Some 65 million people worldwide suffer from epilepsy—a disorder of brain electrical activity that causes recurrent seizures. The usual treatment is antiepileptic drugs (also called anticonvulsants), but around 30 percent of sufferers continue to have seizures despite being on medication—what’s known as drug-resistant epilepsy or refractory epilepsy. 

There’s also the problem of serious side-effects, which include allergies, depression, memory loss, osteoporosis and aplastic anemia.1

The good news is that there are a number of complementary and alternative therapies proving to be effective for drug-resistant epilepsy, especially dietary treatments. Your friend should of course consult with her daughter’s doctor before trying them, but here’s a general guide to what works that you can pass on. 

Go keto

Ketogenic diets, which are high in fat and low in carbohydrates, have proved effective for treating children with epilepsy, and are even included in the UK National Institute for Health and Care Excellence (NICE) guidelines as a treatment for drug-resistant pediatric epilepsy.2

According to a recent review, up to 55 percent of children can achieve freedom from seizures by following a ketogenic diet, while up to 85 percent will see a reduction in seizures. The diet can have side-effects, though, which include constipation and diarrhea,3 so it should be followed under medical supervision.

There are many useful online resources for families considering ketogenic diets for childhood epilepsy, such as www.matthewsfriends.org and www.thedaisygarland.org.uk. And your friend should consult her daughter’s doctor before embarking on the diet—they may be able to refer her to a ketogenic dietitian. 

Investigate allergies

Some evidence has linked food allergies to epilepsy. In a recent preliminary trial of children with drug-resistant epilepsy, an elimination diet was associated with a 50 percent seizure reduction in more than 85 percent of the children studied.6 Consulting with a nutritional therapist can help your friend to identify food allergies and come up with a suitable diet plan, or initially she could try cutting out common culprits like gluten and dairy.

Try other diets

If the ketogenic diet isn’t a good fit for her child, your friend could try the modified Atkins diet. It’s similar but has fewer restrictions, so it might be easier to follow. In one long-term study, 55 percent of children following the diet for more than six months saw their seizures reduce by more than half, and 35 percent were seizure free.4

Another effective option is the low glycemic index (GI) diet,5 which allows more liberal carbohydrate intake than either the ketogenic or modified Atkins diets, but restricts the type of carb-containing foods to only those that cause relatively small changes in blood glucose levels. 

For more information on these diets, see The Epilepsy Foundation’s website, www.epilepsy.com, and speak to a practitioner  before trying them. 

Consider supplements

Certain nutritional supplements may be beneficial for epilepsy, but it’s important to first consult with a qualified practitioner, who can test for nutritional deficiencies and recommend the best supplements along with appropriate, individualized dosages for the child’s weight and needs. 

Here are some general recommendations based on scientific studies in children and adults with epilepsy.

Omega 3s. These essential fatty acids, found in fish oil, appear to have neuroprotective and anti-seizure effects.7 In one study, although a high dose of the omega-3s eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) had no effect, a lower dose was found to reduce the number of seizures the participants had by a third after 10 weeks. Another study looked at whether EPA or DHA was better at reducing seizures in patients with drug-resistant epilepsy, but found that both were similarly effective, and both were significantly better than a placebo.8

Suggested dosage: 1,080 mg/day EPA and DHA

Vitamin B6. A deficiency in this vitamin is common in patients with epilepsy, and there’s even a rare genetic disorder known as “vitamin B6-dependent epilepsy,” mainly occurring in newborns and infants, where seizures can be completely controlled by large doses of vitamin B6 (genetic testing is available to diagnose this). It’s unclear whether B6 will help patients with non-vitamin B6-dependent epilepsy, although there’s some promising evidence from case reports and uncontrolled trials.9 Your friend can consider getting her daughter’s B6 levels tested and then supplementing as needed.

Vitamin E. Studies suggest that adding a vitamin E supplement to standard treatment with antiepileptic drugs can reduce the frequency of seizures.10 It may be because oxidative stress is thought to play a role in epilepsy, and vitamin E is a potent antioxidant.11

Suggested dosage: 400 IU/day

Magnesium. This mineral may be helpful for epilepsy, according to one study of patients with drug-resistant epilepsy. After up to 12 months of taking the supplement, 36 percent of patients saw at least a 75 percent reduction in seizure frequency, and two patients reported complete freedom from seizures.12

Suggested dosage: the effective dose was 420 mg twice a day

Vitamin D. Low levels of vitamin D are common in people with epilepsy.13 And preliminary evidence suggests that correcting vitamin D deficiency can significantly reduce seizure frequency in patients.14 Home testing kits for vitamin D are available via the Vitamin D Society (www.vitamindsociety.org) and Better You (www.betteryou.com), along with personalized recommendations on how much to take.

Listen to Mozart

Studies in adults and children with epilepsy show that listening to Mozart daily can help to reduce seizures.15 In one study, researchers played the first movement of Mozart’s Sonata for Two Pianos in D Major, K.448, every day for three months to epilepsy patients and then switched to a shuffled version that lost the original’s rhythmic qualities. They discovered a significant difference in the number of seizures during the ‘true Mozart’ treatment.16  Your friend could try playing the music to her daughter daily for about 10 minutes before bedtime.

Do yoga

You friend could try doing regular yoga classes with her daughter—the mind-body technique has proved to be a useful add-on therapy for epilepsy.17 In a small randomized controlled trial of children taking antiepileptic drugs, those in the yoga group had no seizures after six months, while seven children in the control group had seizures.18

Neurofeedback

Based on sensitive computer technology, this technique—a form of biofeedback—measures electrical activity in the brain and feeds that information back to help the individual learn how to control seizures. Around three-quarters of patients report fewer weekly seizures with neurofeedback, according to a review of 10 studies.19

One provider in the UK is BrainTrainUK (www.braintrainuk.com); in the US, visit www.isnr.org to find a local provider. 

 

References

1 

Front Neurol, 2016; 7: 218; Epilepsia, 2006; 47: 1232–6

2 

J Hum Nutr Diet, 2020; 33: 98–105

3 

Cochrane Database Syst Rev, 2020; 6: CD001903

4 

J Child Neurol, 2012; 27: 754–8

5 

Seizure, 2014; 23: 570–2

6 

Sci Rep, 2019; 9: 6875

7 

Curr Top Med Chem, 2016; 16: 1897–905

8 

Epilepsy Behav, 2018; 87: 32–8

9 

Altern Med Rev, 2007; 12: 9–24

10

Epilepsia, 1989; 30: 84–9; Adv Biomed Res, 2016; 5: 36

11 

Ann Indian Acad Neurol, 2014; 17: 398–404

12

Can J Neurol Sci, 2012; 39: 323–7

13

Epilepsy Res, 2014; 108: 1352–6

14

 Epilepsy Behav, 2012; 24: 131–3

15

J Sch Nurs, 2018; 34: 28–37

16

Epilepsia Open, 2020; 5: 285–94

17

Cochrane Database Syst Rev, 2017; 10: CD001524

18

J Pediatr Neurosci, 2018; 13: 410–5

19

Clin EEG Neurosci, 2009; 40: 173–9

 

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