What are complementary and alternative therapies?
The term "conventional medicine" refers to the methods and treatments most widely practised by Western health professionals
today to diagnose and treat health conditions. These methods and treatments are based on scientific research. Their effectiveness
is proven and their side effects are well known.
The term "complementary and alternative therapies" (CATs) refers to the use of treatment methods that are not yet approved
by conventional Western medicine or proven by scientific research techniques. This may include physical treatments or procedures,
herbal therapies, vitamins, and other substances.
Strictly speaking, "alternative therapy" refers to using only the non-conventional treatment, whereas "complementary therapy"
means using the non-conventional treatment in conjunction with conventional ones. However, the terms "complementary medicine"
and "alternative medicine" are often used interchangeably.
CATs for epilepsy may be used for lessening the seizures, for alleviating related symptoms, and for reducing side effects.
Some CATs for epilepsy are based on the principle that relaxation may reduce seizures. Others are based on the idea that the
person with epilepsy has less of some vitamin or mineral in his body than is normal. Still others focus
on avoiding certain types of food.
Currently there is mixed scientific evidence on CATs. Studies have been done on them over the years, with some results supporting
their use, some indicating adverse reactions, and some no impact at all.
Once a CAT has been proven or sufficient evidence is collected regarding its effectiveness in a safe manner, it is moved into
the realm of conventional therapies. For example, the ketogenic diet was once considered an alternative therapy, but after
various research studies showed that it was effective, it became a part of the armament of conventional Western medicine in
dealing with epilepsy.
What are your responsibilities as a parent considering CATs?
In cases of epilepsy, people may investigate CATs for various reasons:
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Conventional drugs, such as anti-epileptic drugs, may not be effective in controlling their child's seizures or if they are
effective, the side effects may be intolerable.
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Parents may want to supplement the conventional treatment and improve the overall well-being of their child.
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Surgery may be too risky, not an option, or tried and failed.
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Their cultural beliefs may make the CAT a viable option.
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Parents may have heard of the CAT helping another child with a similar condition.
If you are a parent exploring CAT options for your child with epilepsy, it is important for you to educate yourself fully
on the pros and cons and before you take any action and discuss it thoroughly with your child's doctor.
Practitioners of CATs are often not as strictly regulated as doctors of conventional medicine. Ensure that the practitioner
you consult is properly qualified, reputable, and has experience treating similar cases. Ask the CAT practitioner many of
the same questions you would your regular doctor before beginning a therapy, to make sure you understand:
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its possible side effects
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what to do in case of a seizure
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how to best administer it
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when and how often to give it
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CATs should only be used with great care and under the guidance of a professional. Like conventional Western medicine, CATs
may be potent, may interact with each other and with conventional anti-epileptic drugs, and may have side effects. With some
CATs, there is also the risk that they may be contaminated with other drugs or even heavy metals, or that the dosage will
vary from batch to batch. Like AEDs, prescription of CATs should be done on an individual basis. What works on one type of
seizure or one child may not work in another similar case. Registered and licensed practitioners of CATs exist and both they
and your child's doctor should be consulted before starting a CAT.
CATs should be used along with conventional medicines, not instead of. Do not suddenly stop your child's anti-epileptic medication,
because this can result in very serious withdrawal seizures. Decide upon a schedule for your CAT together with your CAT practitioner
and with the full knowledge and approval of your child's doctor.
Because CATs should be used in conjunction with AEDs, it is necessary to consider any interaction between the two. Ask both
your CAT practitioner and your child's doctor about this.
CATs for epilepsy can be categorized into vitamins and supplements, herbs, diets, and physical therapies.
Vitamins and other supplements
Carnitine
Valproate can reduce the body's supply of carnitine (a vitamin). Your child's doctor may recommend carnitine supplementation
when your child is taking valproate.
Vitamin E
Studies have shown vitamin E to be helpful in reducing seizures in children when used together with conventional anti-epileptic
drugs. Phase IV clinical trials are now being conducted in the U.S. to determine the optimal dose of vitamin E to use in treating
intractable epilepsy in children.
Melatonin
Melatonin is a natural hormone that regulates the biological clock and sleep. It is produced by the pineal gland, located
in the brain. One theory on how it may help people with epilepsy is that it enables better sleep and thereby reduces the risk
of seizures brought on by fatigue.
One study of children with epilepsy found melatonin helpful when taken together with the anti-epileptic drug valproate. Another
study, though, found that melatonin increased the rate of seizures.
The major side effect of melatonin is it can affect the production and use of other hormones in the body, such as the growth
hormone. Other side effects include tiredness, dizziness, depression, confusion, irritability, headaches, low blood pressure,
nausea, stomach cramps, and vomiting.
Taurine
Taurine is an amino acid that plays a role in the activity of the brain. It is thought to have an anti-convulsive characteristic.
One theory is that people with epilepsy have less taurine in their body than normal. Taurine has been shown in some studies
to inhibit seizures.
Vitamin B6
Vitamin B6 has attained the status of an approved, conventional medicine in the treatment of a specific condition, called
pyridoxine-dependent seizures (PDS). This condition can be present in the womb or may show up later. Giving vitamin B6 intravenously
should immediately stop the seizure and normalize the child's EEG readings.
For more information, please see the "Vitamin B6" page.
Herbal therapies
A variety of herbal therapies are sometimes suggested to reduce the frequency and severity of seizures. Herbal remedies are
often perceived as safer than conventional medicines because they are made from plants and are therefore "natural." However,
like conventional prescription and over-the-counter drugs, herbal remedies contain pharmacologically active ingredients that
may have side effects or interactions with other drugs. Use herbal therapies with caution and in consultation with your child's
doctor and your pharmacist.
Diet therapies
The ketogenic diet has been present for many years, is well established, and is now considered a form of convention treatment
for epilepsy.
For more information, please see the "Ketogenic Diet" page.
A small, uncontrolled trial recently found that a modified version of the Atkins Diet has also had some success in treating
intractable epilepsy. Like the ketogenic diet, the Atkins Diet is also high in fat and very low in carbohydrates and so produces
the high level of ketones in the blood necessary to reduce seizures. However, since the Atkins Diet allows more proteins and
calories, it is easier to follow.
Occasionally, seizures may be triggered by food allergies. If you notice that a particular food seems to trigger your child's
seizures, by all means avoid that food.
Physical therapies
Yoga
Yoga is an ancient Hindu system of meditation and low impact exercises to promote control of the body and mind.
Yoga has been explored as a way to reduce seizures because of its aim to reduce stress and promote relaxation. A six-month
study in Delhi showed that yoga altered the EEG of epilepsy patients and reduced their frequency of seizures. New York University's
Comprehensive Epilepsy Center is currently further researching the use of yoga in reducing seizures.
Biofeedback
Biofeedback is a treatment technique in which people are trained to improve their health by using information and signals
from their own bodies. This technique is used for a variety of diseases and by different kinds of specialists to help patients
relax, reduce pain, and regain normal functioning.
In epilepsy, various types of biofeedback may be used to teach patients to consciously control their brain activity and thereby
avoid seizures. The technique may require many sessions to learn and is unlikely to control seizures completely.
A number of studies have looked at the use of biofeedback to treat epilepsy; these studies have shown a reduction in seizures
in some people. However, most of these studies were small and give limited information.
