Site Map

Epilepsy

What is it?

Epilepsy is a condition characterised by sudden disturbances in the electrical impulses of the brain, causing the individual to have a seizure. There are many different causes of seizures so diagnoses of epilepsy, and the type of epilepsy, is based on the type of seizure the patient has. Epilepsy can develop at any time of life. In the UK there are about 420,000 people with epilepsy, about 1 in every 130, of which approximately 43,500 are children.

What causes it?

The causes of epilepsy are still unknown in the majority of cases. In those cases where cause is identified epilepsy can be due to a number of reasons including:

injury to the brain caused by lack of oxygen at birth;
trauma to the head;
stroke;
infections like meningitis or encephalitis;
metabolic disturbance caused by severe lowering of blood glucose levels, or severe malfunctioning of the liver and kidneys;
genetic inheritance;
brain tumour;
alcohol and drug abuse. Seizures can occur either during intoxication or when withdrawing from the substance. Sometimes withdrawal from medications like barbiturates and other sedatives can provoke a seizure if the medication has been taken over long periods.

Types of epilepsy

There are many different types of epilepsy but it is usually divided into the following three groups: symptomatic, idiopathic and cryptogenic epilepsy.

Idiopathic epilepsy starts in childhood or adolescence and is intrinsic to the individual. It is not due to structural change or lesions in the brain and the cause is not known.
Symptomatic epilepsy is thought to be caused by an underlying structural abnormality of the brain.
Cryptogenic epilepsy is a term employed where the cause is suspected but can't be proved.

Types of seizures

Doctors generally use variations of the International Classification of Epileptic Seizures as defined by the International League Against Epilepsy to help them to define the type of epilepsy they are dealing with. Seizures are divided into three categories: generalised seizures, partial (focal) seizures, and epilepsy syndromes.

Generalised seizures: this is when both sides of the brain are involved in the seizure and the individual looses consciousness. There are six main types of generalised seizures.
- Tonic-clonic seizures (grand mal): these last from 3 to 4 minutes and describe the action of the seizure. Tonic means contracting and the muscles of the individual contract and become so rigid they fall to the ground. Muscles around the lungs also contract causing the recognisable involuntary 'epileptic cry'. Clonic means convulsive and this is what happens after the contraction of the muscles, a rhythmic convulsion.
- Tonic seizures: this type of attack only has the rigid phase.
- Clonic seizures: this type of attack only has the convulsive phase.
- Atonic seizures (or drop attacks) - this is where loss of muscle tone occurs and the individual may fall to the ground.
- Myoclonic seizures: sudden muscle jerks.
- Absence seizures (petit mal) consciousness is absent due to an interruption of brain activity. They sometimes last only a few seconds and so can be missed and are more prevalent in girls than boys.
Partial (focal) seizures: these begin at a particular point in the brain but may also spread to the whole brain and become what is known as a secondarily generalised seizure. Consciousness may be lost depending on whether the seizure is simple or complex. There are two types of partial (focal) seizures.
- Simple partial seizures (also known as Jacksonian seizures). Consciousness will be unaffected as long as the seizure activity remains within a small area. If however, activity spreads over both hemispheres of the brain, the seizure becomes a secondarily generalised seizure and the individual will lose consciousness. In these cases the simple seizure is a warning of the bigger attack and is known as an aura. There are many different auras or warnings of attacks; the most common are a feeling of nausea and a feeling of fear.
- Complex partial seizure these occur when seizure activity spreads to a larger area of the brain so affecting the individual's consciousness
  more.
Epilepsy syndromes: this term is employed when seizures seem to follow recognisable patterns or typical courses, however a clear diagnosis is not always possible but is useful for both prescribing treatment and for predicting the likely outcome or prognosis. The following is a list of syndromes that occur in childhood. For more information on specific syndromes contact the epilepsy organisations listed at the end of the fact sheet.
- Benign rolandic epilepsy of childhood (BREC) also known as benign
  partial epilepsy with centro-temporal or rolandic spikes.
- Juvenile myoclonic epilepsy (JME) also known as Janz Syndrome
- West syndrome, also known as infantile spasms or salaam spasms
- Lennox-Gastaut syndrome
- Landau-Kleffner syndrome (LKS)
- Sturge-Weber syndrome (SWS)
- Rasmussen's syndrome
Some conditions that affect the brain, such as cerebral palsy, autism and learning difficulties, can increase the likelihood of epilepsy, due to the underlying brain damage that has caused both conditions. For those with the two conditions combined, the epilepsy is likely to be of a more severe form, sometimes called 'epilepsy plus'. Some 30%-40% of children who develop epilepsy below the age of 16 will outgrow it before adulthood. Unfortunately though, it is impossible to predict an individual's prognosis.
Status epilepticus. This is an extremely dangerous occurrence and is the term for seizures that last for at least 30 minutes, or for seizures that occur one after another for a period of 30 minutes with no return to consciousness in between. The dangers of status epilepticus are brain damage, and sometimes death, caused by lack of oxygen to the brain. To counter status epilepticus anti-epileptic drugs need to be injected into the muscles or the veins.

Women and Epilepsy

Women who have epilepsy often report that their seizures bear some relation to their menstrual cycle. Many women find they have more seizures around ovulation or around menstruation (catamenial epilepsy). It is thought that they may be caused by changes in levels of the hormones oestrogen and progesterone, or to alterations in body fluids which affects the efficacy of anti-epileptic medication.

Epilepsy and pregnancy

Anti-epileptic drugs can lead to complications in pregnancy. There is a definite risk of malformation of the foetus caused by drugs (see under medication below for further information). Conversely, if the pregnant woman experiences a tonic-clonic seizure this can lead to lack of oxygen to the foetus with the risks that that presents. Miscarriage in early pregnancy, premature labour in more advanced pregnancy, and injury are additional risks of uncontrolled epilepsy. Anti-epileptic drugs deplete the supply of folic acid, so women planning to conceive should take a higher dose than that usually recommended. However this should be done with your doctor's knowledge, as some research seems to show that this makes the epilepsy worse.

Foldvary N. Treatment issues for women with epilepsy. Neurol Clin 2001 May;19(2):409-25 "Affected women are unaware of many of the unique issues they face, including the relationship between antiepileptic drug therapy and contraception, the risk of abnormal pregnancy outcomes, the effect of hormones and aging on seizure control, and the increased incidence of reproductive dysfunction. "

Sudden unexplained death in epilepsy

There are believed to be between 200 and 500 deaths due to epilepsy in the UK alone, and the risk of a premature death in people with epilepsy is about 2 to 4 times higher than the population in general. The highest risk group is young men (between 20 and 30) with uncontrolled epilepsy and who experience tonic-clonic seizures.

Treatment

There are a number of different ways of dealing with epilepsy including surgery, anti-epileptic medication; alternative therapies, the ketogenic diet and self-help.

1. Surgery
All surgery for epilepsy is performed on the brain. The area of the brain involved depends on the type of epilepsy. Surgery for epilepsy is relatively safe with complications occurring only in 4% of operations (4). There are five types of surgery: lobectomies; corpus callosotomies; hemispherectomies; and multiple subpial transection.

Lobectomies
This is where an area of the brain (called a lobe) is removed either partially or totally. This type of surgery is performed if the seizure originates in the same area of the brain each time. It is only performed if the area of the brain removed does not affect vital functions.
Corpus callostomies (split brain surgery)
This surgery is performed on those whose epilepsy does not originate in one area of the brain but both sides at once. The corpus callosum is the name of the nerve fibres connecting one side of the brain to the other and a corpus callostomy cuts these nerve fibres with the aim of stopping the spread of the seizure. Although this procedure does not entirely stop seizures it usually significantly reduces the number of seizures and their effects are generally less severe.
Hemispherectomy
This is carried out when the epilepsy is caused by severe brain disease on one side of the brain and so the complete hemisphere is removed. In children the half that is left often takes over some of the functions of the removed half, however there will be some noticeable effects of weakness and loss of some movement on the opposite side of the body to the hemisphere removed, and also a loss of peripheral (side) vision.
Multiple subpial transection (MST)
When seizures originate in the parts of the brain that are responsible for vital function it is not possible to remove them so a MST is performed. It involves making small incisions in the brain, which interfere with the spread of seizure impulses.

Other surgical interventions:

Lesionectomy
Surgeons at the Mayo Clinic in Rochester, Minnesota have pioneered a surgical technique that gives them access to the most remote and sensitive areas of the brain. Using a computer, a surgeon can view and vaporise the tiny tumours that cause some cases of epilepsy. The procedure can be performed with minimal damage to the healthy tissue in the brain.
Vagus nerve stimulation
This involves surgery, but not brain surgery. Vagus nerve stimulation consists of a small programmable pulse generator (a type of battery that can last up to 12 years) that is implanted under the skin of the left upper chest with electrodes running under the skin and connected to the vagus nerve in the neck. The doctor programs the device to deliver short bursts of electrical energy to the brain via the vagus nerve. If necessary the patient or a companion can use a magnet to stimulate the generator for an extra burst of electrical energy, if a seizure seems imminent. The vagus nerve is used because it contains few if any pain fibres, over 80% of the electrical signals applied to the vagus nerve in the neck are sent upwards to the brain, and connecting the device does not involve brain surgery. Side effects of vagus nerve stimulation seen so far have been voice change, throat discomfort, a feeling of shortness of breath and a cough.

Vagus nerve stimulation does not cure epilepsy, but according to research seems to substantially improve the overall quality of life of a third of patients who use it, another third experience a good improvement in the quality of life, while the remaining third experience little or no improvement. As yet there is no way to determine how an individual will respond to the therapy.

Vagus nerve stimulation has been available in the UK for about 4 years now and is performed at various hospitals around the country. A neurologist usually recommends vagus nerve stimulation after they have decided that
phamacalogically and surgically they can go no further. Some health authorities do not provide VNS on the national health. If this proves to be the case there is a charity, set up to help individuals find funding so that the procedure can be carried out.

Research:

- Patwardhan RV, Stong B, Bebin EM, Mathisen J, Grabb PA. Efficacy of vagal nerve stimulation in children with medically refractory epilepsy.
Neurosurgery 2000 Dec;47(6):1353-7; discussion 1357-8
"VNS should be considered for children with medically refractory epilepsy who have no surgically resectable focus."

For further information contact:

F.A.B.L.E (For A Better Life with Epilepsy)
Ashgate House
9-13 Ashgate Road
Broomhill
Sheffield S10 3BZ
Tel: 0800 521629
Website: http://www.fable.org.uk
Fable help put people in touch with others in the same situation, and in the future they aim to open respite care homes.

Cyberonics, Inc
16511 Space Centre Boulevard
Suite 600
Houston
TX 77058-9798
USA
Tel: 888-VNS-STIM (867-7846)
http://www.cyberonics.com/

2. Anti-epileptic Medication

Anti-epileptic medication is the main method of managing seizures. The following are the most common anti-epileptics.

Acetazolomide
Depakene (valproic acid)
Dilantin (phenytoin)
Epival (valproate)
Frisium (clobazam)
Lamictal (lamotrigine)
Mogadon (nitrazepam)
Mysoline (primidone)
Neurontin (gabapentin)
Phenobarbitol
Phenobarbitone
Piracetam
Rivotril (clonazepam)
Sabril (vigabatrin)
Sodium valproate
Tegretol (carbamazepine)
Topiramate
Zarontin (ethosuximide)

Side effects of anti-epileptic medication include lethargy, tiredness, skin rash and dizziness.

For further information contact:

Website: http://www.rxlist.com
- gives details of specific drugs and their side-effects.

Risks of using anti-epileptic drugs in pregnancy
Use of anti-epileptic drugs in pregnancy can interfere with the formation of the nervous system and specifically the formation of the neural tube from which the brain and spinal cord develop. This can lead to anything from minor abnormalities of the vertebrae, to mal-development of the spinal cord and resultant weakness of legs and loss of bladder control. Spina bifida is one of the groups of malformations caused by neural tube defects. Women planning to conceive or who are pregnant should discuss this issue with their doctor.

3. Alternative therapies (in alphabetical order)

It is strongly recommended to carry on with the treatment prescribed by your
doctor.

Acupuncture
This is the most well known therapy in traditional Chinese medicine. It follows the principle that disease or physical disharmony is caused when the energy flow or "chi" is obstructed. There are twelve meridians in the body and each one is associated with a specific organ. Acupuncturists endeavour to rebalance the chi so that it can circulate freely through the meridians. Very fine sterilised needles are inserted through the skin at specific points of the body. They are usually left for a short while which is believed to cause little discomfort. By slightly manipulating
or twirling them, the therapist can either draw the energy to the meridians or away from them. It is common to insert needles at a considerable distance from the point on which they are to act and similarly successive points on a specific meridian may affect different areas or conditions.

Acupuncture is thought to work on the limbic centre of the brain, the area that is involved in moods and emotions and often implicated in epilepsy. While therapists do not suggest they can cure epilepsy they may in the long term be able to reduce levels of stress and anxiety, which in itself will reduce the risk of seizures.

One effect of needling is the release of a natural substance called GABA, which is similar to the chemicals used in anti-epileptic medication.

It is thought that acupuncture may relieve pain and spasms as well as improve muscle tone.

Acupuncture is often used in conjunction with traditional Chinese herbal medicine (see below).

Research:
- Yang R, Huang ZN, Cheng JS. Anticonvulsion effect of acupuncture might be related to the decrease of neuronal and inducible nitric oxide synthases. Acupunct Electrother Res 2000;25(3-4):137-43
- Stavem K, Kloster R, Rossberg E, Larsson PG, Dahl R, Kinge E, Lossius R, Nakken KO. Acupuncture in intractable epilepsy: lack of effect on health-related quality of life. Seizure 2000 Sep;9(6):422-6
The authors could not demonstrate a significant effect of traditional acupuncture on epilepsy

(For more information see our fact sheet on acupuncture)

British Acupuncture Council
63 Jeddo Road
London
W12 9HQ
Tel: 020 8735 0400
http:// www.acupuncture.org.uk

British Medical Acupuncture Society
12 Marbury House
Higher Whitley
Warrington
Cheshire WA4 4QW
Tel: 01925 730 727
http://ww.medical-acupuncture.co.uk
Alexander technique
The aim of Alexander technique practitioners is to teach their patients how to improve the awareness of their body and its functions, in order to use it better. It is based on the idea that movement should involve a lengthening and widening of the body that relieves any tension. The technique is usually taught on a one-to-one basis, the teacher makes the patient aware of what optimum posture feels like before beginning to make adjustments and re-educating them in the use of their muscles, the goal being to produce maximum efficiency with minimum effort. Practitioners focus on the use of the body in sitting, standing and walking. All sorts
of movements and activities will be considered in the course of a programme of treatment.

Alexander technique is thought to be helpful to people with epilepsy, as their bodies can often become misaligned as an after-effect of seizures.

(For more information see our fact sheet on the Alexander technique)

The Society of Teachers of the Alexander Technique (STAT)
129 Camden Mews
London NW1 9AH
Tel: 020 7284 3338
http:// www.stat.org.uk
Aromatherapy
Warning: some oils may cause seizures, always seek the advice of a professional who knows about and understands epilepsy.

Aromatherapy can work on a number of levels for people with epilepsy in that it can be both psychologically and physically relaxing, lowering stress levels and thereby lowering the risk of stress-induced seizures. An aromatherapy massage can, in some instances, ward off a seizure. Work has been done at Birmingham University to help patients create a memory link between the smell of an oil and the state of relaxation. Once this has been created just the smell of the oil will recreate the state of relaxation.

Birmingham University's Seizure Clinic has used visualisation techniques and hypnosis to help patients with epilepsy remember smells of certain oils in order to recreate for themselves the feeling of relaxation they experienced during a massage. In one study 10 patients were followed for two years. At the end of the study 6 were seizure-free and 3 were able to withdraw from medication.

Oils such as ylang ylang, camomile and lavender have a relaxing and calming
effect. However other oils including hyssop, rosemary, sweet fennel, clove, nutmeg camphor and sage have the opposite effect and should be avoided by people with epilepsy.

Oils can be inhaled, one or two drops on a handkerchief can be held to the nose or put into a diffuser or oil burner. Oils can also be used in a bath. If massaged onto the skin they must be diluted in a carrier oil first as some are very strong and may act as an irritant.

(For more information see our fact sheet on aromatherapy)

International Federation of Aromatherapists (IFA)
182 Chiswick High Road
London W4 1PP
Tel: 020 8742 2605
http://www.int-fed-aromatherapy.co.uk

International Society of Professional Aromatherapists
ISPA House
82 Ashby Road
Hinckley
Leicestershire LE10 1SN
Tel: 01455 637 987

The Register of Qualified Aromatherapists
PO Box 3431
Danbury
Chelmsford
Essex CM3 4UA
Tel: 01245 227957
http://www.rqa-uk.org
Biofeedback
Biofeedback (also called electroencephalographic biofeedback, or neurofeedback) is the process of moderating, limiting or changing certain physiological functions previously thought to be involuntary, such as heart rate, blood pressure, brain waves, etc. Electrodes are attached to the body and an electroencephalogram (EEG) gauges brain wave activity. Physiological information such as heart rate, skin temperature (indicating the flow of blood) and muscle tautness are also recorded. Initially, an individual's brain waves are mapped and analysed to find any deviations from the norm. Then, with the aid of a biofeedback practitioner, the patient concentrates on altering their brain wave activity. This is done by rewarding a patient with positive feedback when the brain waves find their way into the optimal state set by the practitioner. With repeated effort and patience, the patient can learn to raise skin temperature, diminish muscle tension and alter brain wave activity.

For epilepsy, results are unpredictable. Reductions in seizure activity are reported in 50% of patients with intractable seizures (seizures resistant to medication), some people have lowered their drug dosage or withdrawn completely from medication without side effects, while using biofeedback. Success may be linked to positive attitudes, or to the sense of self-control that the procedure produces both of which may have their own moderating impact on stress, and therefore seizures. The reduction of stress in everyday life has been one of the most beneficial aspects of biofeedback. The technique has also been found to help people become aware of auras, which may precede their seizures, allowing them the opportunity to try to abort a seizure before it occurs.

Unfortunately treatment is very expensive and time consuming, with the individual needing anything from 5 to over 100 sessions in order to manage their brainwave activity.

Research:

- Uhlmann C, Froscher W. Biofeedback treatment in patients with refractory epilepsy: changes in depression and control orientation Seizure 2001 Jan;10(1):34-8 "Biofeedback is able to improve internal control orientation through personal success mediation."

- Swingle PG. Neurofeedback treatment of pseudoseizure disorder. Biol Psychiatry 1998 Dec 1;44(11):1196-9
"These findings support the view that theta-SMR feedback training, in conjunction with psychotherapy, is an effective adjunctive treatment for pseudoseizure disorder."
(For more information see our fact sheet on biofeedback)

EEG Neurofeedback Services
Dolphin Lodge
Dolphin Yard
Holywell Hill
St. Albans
Herts AL1 1EZ
Tel: 01727 839533
http://www.eegneurofeedback.net/

EEG Spectrum
Neurofeedback Research and Clinical Services
16500 Ventura Blvd
Suite 418
Encino
CA 91436-2011
http://www.eegspectrum.com/
Chiropractic
Chiropractic, which means "done by hand", is very similar to osteopathy (see below): it is based on the theory that the state of the nervous system in a person affects their health. The key element of the body structure is the spine, it is the link that carries nerves to the whole body. The vertebrae encase the tail of the brain which has an effect on the main bodily functions such as digestion, blood flow, heartbeat, the immune system and breathing. When there is nerve interference caused by spinal subluxations (misaligned vertebrae), there is dis-ease. Through manipulations the chiropractor can realign the vertebrae and thereby release the pressure on the spinal cord and nerves.

There are two schools of chiropractors in the UK: McTimoney practitioners and regular chiropractors. The former focus on the whole body during the session in the belief that complete realignment is necessary each time, they also emphasise self-help and teach patients a set of exercises to do at home; the latter concentrate on specific areas. Chiropractic is not believed to cure epilepsy but it is thought that it can relieve some of the stresses on the brain that may contribute to seizures. Some people have reported that sessions have triggered seizures and it is thought that practitioners who favour a gentle approach are most beneficial.

Research:

- Pistolese RA. Epilepsy and seizure disorders: a review of literature relative to chiropractic care of children. . J Manipulative Physiol Ther 2001 Mar-Apr;24(3):199
"It is suggested that chiropractic care be further investigated regarding its role in the overall health care management of pediatric epileptic patients"

- Alcantara J, Heschong R, Plaugher G, Alcantara J. J Manipulative Physiol Ther 1998 Jul-Aug;21(6):410-8. Chiropractic management of a patient with subluxations, low back pain and epileptic seizures
"Results encourage further investigation of possible neurological sequalae, such as epileptic seizures, from spinal dysfunction identified as vertebral subluxation complexes by chiropractors and treated by specific spinal adjustments."

(For more information see our fact sheet on chiropractic)

British Chiropractic Association
Blagrave House
17 Blagrave Street
Reading
Berkshire RG1 1QB
Tel: 0118 950 5950
http:// www.chiropractic-uk.co.uk

General Chiropractic Council
344-354 Gray's Inn Road
London WC1X 8BP
Tel: 020 7713 5155
http://www.gcc-uk.org/

McTimoney Chiropractic Association
21 High Street
Eynsham
Oxford OX49 4HE
Tel: (01865) 880974
http://www.mctimoney-chiropractic.org/

British Association for Applied Chiropractic
167a London Road
Teynham
Kent ME9 9QJ
Tel: 01795 520 707
Cranial osteopathy
Cranial osteopathy was developed as an extension to the osteopathic approach (see below); it is a popular form of therapy for children as it is very gentle and non-invasive. It is based on the observation that the bones of the cranium (the part of the skull, which surrounds the brain) fuse into immobility in adults but in babies and young children these bones are flexible. Cranial osteopaths believe that the pulsing of the fluid which nourishes and protects the membranes surrounding the brain, spinal cord and sacrum can be detected by placing their hands on the skull; the name given to this pulsing is Cranial Rhythm Impulse (CRI). The practitioner will delicately manipulate the cranial and spinal bones to restore the CRI (which should be at a rate of six to fifteen times per minute); this is believed to boost blood circulation as well as the drainage of lymph and sinus fluids in the head. The cranial osteopath does not only work with the cranium or the sacrum.Instead he or she includes these areas in an overall evaluation and treatment plan, considering the whole body as one dynamic, integrated unit of function.

It is thought that cranial osteopathy may help stabilise tiny movements of the brain, which may improve some epilepsy. The brain has different rhythms and blood flows of its own and the treatment may also treat tiny aberrations of independent movement made by the brain within its fluid. Cranial osteopathy is also thought to help the central nervous system to work as freely as possible, helping the body's own self-healing mechanisms to work better, thus improving the individual's general condition, and indirectly, their epilepsy.
Craniosacral osteopathy
This is another form of cranial osteopathy and is described as a more subtle treatment as it focuses on the membranes encasing the brain and spinal cord, in contrast to the focus on the bones of the cranium. Practitioners believe that the membranes generate the cranial rhythm and that this rhythm affects every cell in the body. The treatment consists of light touch on the various points of pulsation. Craniosacral osteopathy is thought to be particularly effective for young children and babies. Craniosacral osteopathy is not thought to cure epilepsy but, as with cranial osteopathy, aims to ensure that the central nervous system is working as freely as
possible, helping the body's own self-healing mechanisms to work better, thus improving the individual's general condition and, indirectly, their epilepsy.

(For more information see our fact sheet on cranial and sacrocranial osteopathy)

The International Cranial Association
478 Baker Street
Enfield
Middlesex EN13QS
Tel: 020 8367 5561

Osteopathic Centre for Children (OCC)
109 Harley Street
London W1G 6AN
Tel: 020 7486 6160
http://atschool.eduweb.co.uk/felsted/occweb/more.htm

The Upledger Institute UK
2 Marshall Place
Perth PH2 8AH
Scotland
Tel: 01738 444404
http://www.upledger.com

Craniosacral Therapy Association of the UK
Monomark House
27 Old Gloucester Street
London WC1N 3XX
Tel: 0700 0784 735
http://www.craniosacral.co.uk/
Herbalism
Chinese herbalism
According to traditional Chinese herbal medicine epilepsy is diagnosed as phlegm or dampness caused through a blocked heart meridian which disturbs the spirit. A Chinese doctor will aim to restore balance and will sometimes use acupuncture (see above) as well. As with most alternative remedies Chinese herbalism does not claim to cure epilepsy but it may help reduce the number of attacks experienced by the individual.

Some commonly used herbs include:
- sweet flag root
- Chinese senegar root
- Bamboo shavings or bamboo juice
- Qingyang shen has been used in Chinese cultures for at least 2,000 years to help control seizures. It has anti-epileptic properties and research has shown that it helps decrease seizures in rats.
Sometimes a diet may be prescribed which may exclude sugar, fried foods, dairy products and alcohol.

Research:

- Chiou LC, Ling JY, Chang CC. Chinese herb constituent beta-eudesmol alleviated the electroshock seizures in mice and electrographic seizures in rat hippocampal slices. Neurosci Lett 1997 Aug 15;231(3):171-4
"The potential of beta-eudesmol to serve as an antiepileptic or a conjuvant in phenytoin therapy is suggested."

For further information contact:

The Register of Chinese Herbal Medicine RCHM
Office 5
Ferndale Business Centre
1 Exeter Street
Norwich NR2 4QB
Tel: 01603 623994
http://www.rchm.co.uk/

The British Kanpo Association
Kailash Centre
7 Newcourt Street
London NW8 7AA
Tel: 020 7722 3939
Kampo is Chinese Herbal Medicine in Japan
Herbal Medicine (also called Phytotherapy).
People with epilepsy should use herbal medicine with caution as some herbs can trigger attacks. It is not wise to buy over-the-counter products, and as anyone can set up as a herbalist, it is best to check the practitioner's qualifications.
Herbs said to be good for epilepsy include:
- Blue vervain, for absence seizures, especially if associated with seizures triggered by menstrual attacks.
- Hyssop, which may be used in absence attacks.
- Lobelia, which is said to have a general depressant action on the central nervous system and so can be prescribed for epilepsy.
- Skullcap, which is supposed to relax states of nervous tension and the central nervous system.
- Chinaberry. Chinaberry juice has been studied in animals for its anti-convulsive properties. Results suggest that it may contain an ingredient that has long-acting anti-epileptic power.
  Nine-Herbal Extract. This has been used by the Japanese to help decrease seizures. Researchers are reported to have found that it decreases seizures in mice.
- Cannabis/Marijuana. Cannabis is an anti-convulsant, analgesic, used as a sedative or narcotic agent. A study in 1980 by Dr J Cunha seemed to show that cannabis had beneficial effects for people with epilepsy. However, reliable documentation of the effectiveness of marijuana as an anti-epileptic medication is extremely limited at this time. While some accounts show a reduction in seizure frequency and/or severity in some people who have epilepsy, others suggest that marijuana may actually trigger seizures in some people. Because the potency and chemical composition varies widely between plants and growing conditions, the use of marijuana would have to be carefully controlled using scientific testing. Further investigation is needed to determine the effectiveness of cannabis as an anti-epileptic drug, as well as to determine the potentially negative side effects associated with its use. The Canadian federal government recently approved research into the medicinal use of cannabis in controlled clinical settings. With further research, the potential benefits and risks of marijuana use will be better understood.
  
  Cannabis can only be prescribed in the UK with special permission from the Home Secretary and Doctors risk being struck off if they prescribe cannabis illegally. Some individuals have reported weaning themselves off of anti-epileptic medication and remaining seizure-free, if on cannabis. However, this entails breaking the law with a penalty of a fine and/or imprisonment if discovered.
  
  Herbs to be avoided include:
  - Evening primrose oil. It is said to aggravate temporal lobe epilepsy.
  - Sage is also believed to be dangerous.
  Research:
  
  - Kim HJ, Moon KD, Oh SY, Kim SP, Lee SR. Ether fraction of methanol
  extracts of Gastrodia elata, a traditional medicinal herb, protects against kainic acid-induce neuronal damage in the mouse hippocampus.
  Neurosci Lett 2001 Nov 13;3141
  
  - "Gastrodia elata (GE) has been used traditionally for the treatment of convulsive diseases such as epilepsy in oriental countries including South Korea and still occupies an important place in traditional medicine in Asia. Our results show that The EFME of GE has anticonvulsive effect and putative neuroprotective effect against excitotoxicity induced by kainic acid."
  
  - Dendle P. Lupines, manganese, and devil-sickness: an Anglo-Saxon medical response to epilepsy. Bull Hist Med 2001 Spring;75(1):91-101
  The most frequently prescribed herb for "devil-sickness" in the vernacular medical books from Anglo-Saxon England, the lupine, is exceptionally
  high in manganese. Since manganese depletion has been linked with recurring seizures in both clinical and experimental studies, it is possible that lupine administration responded to the particular pathophysiology of epilepsy.
  
  For further information contact:
  
  BHMA Publications,
  P.O. Box 304,
  Bournemouth,
  Dorset. BH7 6JZ
  Tel: 01202 433691
  
  The National Institute of Medical Herbalists
  56 Longbrook Street
  Exeter EX4 6AH
  Tel: 01392 426022
  http://www.nimh.org.uk/
Homeopathy
Homeopathy was developed by Samuel Hahnemann in the eighteenth century and is based on the theory that like cures like. Homeopathic remedies are diluted to such a degree that only a trace of the original substance is left, but practitioners believe that even this trace amount is sufficient to stimulate the body's self-healing abilities. Hahnemann believed that the more a remedy was diluted the more specific the effect seemed to be. As the remedies are diluted so much, homeopathy does not cause any side effects, although symptoms often get worse before they begin to get better, something that people with epilepsy need to discuss with their homeopath. In the UK homeopathy was included as part of the national Health Service when it was founded in 1948.

Remedies come in the form of lactose tablets, pillules, powder, granules, or as a liquid. Remedies should be taken at least half an hour after a meal and no food or drink should be taken for at least 10-15 minutes before or after a dose. Practitioners often advise avoidance of strong-tasting substances such as peppermint, tobacco and menthol. Long-standing complaints are believed to take longer to treat than ones that developed recently.

Practitioners look at the whole person when prescribing a remedy, not just the condition they are suffering from, and will ask a whole range of questions about the medical history, moods, likes and dislikes, diet etc. Advice about diet and lifestyle may also be given along with the remedy.

There has been some anecdotal success reported with epilepsy but as treatment is individually tailored it is impossible to say what might be useful for any particular person.

Treatments that have been used include:
- Artentum
- Nitricum
- Caulophyllum
- Causticum
- Cicuta
- Cocculus
- Crotalus
- Cuprum
- Glonomium
- Ignatia
- Nux vomica
- Plumbum
- Pulsatilla.
Some homeopaths also make use of flower remedies, such as Bach's flower remedies. Californian and Bush remedies have also become popular.

(For more information see our fact sheet on homeopathy)

British Homeopathic Association
15 Clerkenwell Close
London EC1R 0AA
Tel: 020 7566 7800
http://www.trusthomeopathy.org

The Society of Homeopaths
4a Artizan Road
Northampton NN1 4HU
Tel: 01604 621400
http://www.homeopathy-soh.org

Homeopathic Medical Association
6 Livingstone Road
Gravesend,
Kent DA12 5DZ
Tel: 01474 560336
http:// www.homoeopathy.org
Hypnotherapy
Although many different cultures throughout the ages have used healing trances, hypnotherapy is understood to have come out of the work of Franz Anton Mesmer, an eighteenth century Austrian Doctor. Practitioners believe that the mind has different levels of consciousness and that in a state of hypnosis the conscious rational part of the brain can be bypassed leaving the subconscious part of the brain open to suggestion. It is believed that 90% of the population can be hypnotised and that of those 10% are highly hypnotisable, so much so that minor operations can be performed without anaesthetics. Both the UK and US Medical authorities recommend the inclusion of hypnosis in Medical training, but to date this rarely
happens.

For people with epilepsy self-hypnosis techniques can be taught to induce a state of deep relaxation and Dr John Barry, professor psychiatry and behavioural sciences at Stanford, has trained several of his own patients in self-hypnosis techniques to trigger seizures, and then stop them.

For further information contact:

The National College of Hypnosis and Psychotherapy (NCHP)
12 Cross Street
Nelson
Lancashire BB9 7EN
Tel: 01282 699378
http://www.hypnotherapyuk.net

British Society of Clinical Hypnosis
125 Queensgate
Bridlington
Yorkshire YO16 7GQ
Tel: 01262 403103
http://www.bsch.org.uk

London College of Clinical Hypnosis
15 Connaught Square
London W2 2HG
Tel: 020 7402 9037
http://www.lcch.co.uk
Magnetic Stimulation
There is some evidence that the application of a low frequency magnetic stimulator against the head, which delivers repetitive Transcranial Magnetic Stimulation (TMS), can help the number or severity of seizures in patients who suffer from refractory epilepsy. The effects of treatment are observable after 6 to 8 weeks. Research is still in its early stages.
Meditation
Meditation is a form of mental discipline intended to induce a state of profound relaxation, inner harmony and increased awareness. Forms of meditation are used in all of the world's religions, however there is no need to adhere to a particular belief system in order to benefit from the practice.

There are many different techniques designed to get the individual into the meditative state, so it is worth looking around to see which suits you best. Some people find that active meditation suits them better, like t'ai chi, walking or swimming.

When monitored by an electroencephalograph (EEG), the alpha waves of an individual in a meditative state are of a higher intensity than those produced when the same individual is sleeping. This indicates the level of relaxation attained through meditation is more profound than that achieved by sleep.

A study at the Department of Physiology, the All India Institute of Medical Sciences, New Delhi, has shown that people with drug-resistant epilepsy achieved substantial improvements with the help of meditation, reducing both the length and frequency of seizures.

Research:

- Panjwani U, Selvamurthy W, Singh SH, Gupta HL, Mukhopadhyay S, Thakur L. Effect of Sahaja yoga meditation on auditory evoked potentials (AEP) and visual contrast sensitivity (VCS) in epileptics. Appl Psychophysiol Biofeedback 2000 Mar;25(1):1-12
"The reduced level of stress following meditation practice may make patients more responsive to specific stimuli. Sahaja Yoga meditation appears to bring about changes in some of the electrophysiological responses studied in epileptic patients."

For more information contact:

School of Meditation
158 Holland Park Avenue
London W11 4UH
Tel: 020 7603 6116

Friends of the Western Buddhist Order
London Buddhist Centre
51 Roman Road
London E2 0HU
Tel: 0845 458 4716
http://www.lbc.org.uk/

Transcendental Meditation (founded by Maharishi Mahesh Yogi)
London Centre
24 Linhope Street
London NW1 6HT
Tel: 020 7402 3451
Melatonin
Researchers have found that melatonin lowers the excitability of individual neurons and acts as a mild anticonvulsant. Patients with epilepsy whose brain wave patterns were evaluated both before and after the injection of melatonin displayed normalised brain waves following melatonin injection. Recent data from biochemical and electrophysiologic studies support the idea that the anticonvulsant and depressive effects of melatonin on neuron activity may depend on its antioxidant and antiexcitotoxic roles (ie acting as a free-radical scavenger and brain glutamate receptor regulator).

Research:

-Chao DM, Chen G, Cheng JS. Melatonin might be one possible medium of electroacupuncture anti-seizures. Acupunct Electrother Res 2001;26(1-2):39-48
"A further elevation of MT (melatonin) levels with EA treatment suggests that MT might be one of the possible mediums of EA (electroacupuncture) anti-seizures."
Naturopathy
Based on the principle of homeostasis - that the body can heal itself and will always strive towards good health - naturopathy can trace its guiding principles back to Hippocrates who formulated them over 2,000 years ago. It came out of the "nature cures" popular in the spa towns of 19th century Germany and Austria and its name was coined by Dr John Scheel of new York in 1895.

Good health is believed to be dependent on a number of factors working together: a healthy diet (wholefood, preferably organic); plenty of exercise and fresh air; and adequate sleep. Lack of these things plus pollution, negative attitudes and emotional or physical stress, can lead to a build up of "toxins" which can overload the immune system and upset the balance necessary to maintain good health.

The naturopath believes in the healing power of natural resources. Treatment is aimed at improving the patients' "vital force" which helps the body fight off disease. Naturopaths take a holistic approach and look for underlying causes of the presenting symptoms, believing that fevers and inflammation signify a weakening of the vital force. If treatment is directed only at the symptom, the underlying problem could cause further deterioration and resurface at a later date. Practitioners look at the patient's "Triad of Health", (their emotional well-being, their musculo-skeletal structure and their internal biochemistry), and then prescribe a range of therapies
designed to improve circulation and digestion, increase the elimination of waste products and boost the immune system. These will vary according to the practitioner and may include fasting, diet and supplementation, hydrotherapy, physical therapies, life-style modification, counselling and touch therapies.

Many of the principles of naturopathy underpin conventional medical thought today and there is a lot of agreement about the importance of a wholefood diet low in fat and salt and high in fibre and antioxidants. However if planning a fast or restricted diet, ensure that the naturopath is qualified.

For epilepsy a practitioner might look for nutritional imbalances and food allergies and intolerance (see below under Nutrition), as well as considering psychological factors and exercises.

For further information contact:

General Council and Register of Naturopaths
Goswell House
2 Goswell Road
Street
Somerset BA16 0JG
Tel: 08707 456 984
http://www.naturopathy.org.uk/

The British College of Naturopathy and Osteopathy
Lief House
3 Sumpter Close
120-122 Finchley Road
London NW3 5HR
Tel: 020 7435 6464
http://www.bcno.org.uk
Nutrition
Anti-epileptic drugs can deplete nutrients and certain nutritional deficiencies have been associated with seizures.

Vitamin shortages to be aware of include:
- Vitamin B6 (pyriodoxine). Shortage of this vitamin seems to bring on seizures in some people although the helpfulness of extra doses is very variable. Good sources of B6 include meat, whole grains and pulses. Once vitamin B6 is increased there is an automatic need for other B Vitamins so it may be helpful to take Vitamin B complex which helps with the smooth running of the central nervous system. Vitamin B complex also helps improve blood flow throughout the body, so ensuring that the brain is well supplied with oxygen. However, it is best to consult a practitioner if taking this supplement as some people develop neuropathy (abnormality of the nervous system) at incorrect doses.
- Calcium deficiency (hypocalcaemia) - this has been identified as a metabolic disorder especially in newborn babies which may bring on seizures. Calcium can also be lost through the urine as a result of kidney disease. It is worth checking with a doctor that there is no underlying problem causing calcium deficiency. The best sources of calcium are milk and dairy products. Calcium is also found in bony fish, seeds, nuts dried figs, bread and dark leafy vegetables.
- Vitamin D. This helps with the absorption of calcium and is also useful in its own right. Sources include oily fish, eggs and cheese.
- Vitamin E. This aids the flow of oxygen around the body. Sources include wheatgerm, avocados and eggs (especially the yolk).
- Folic acid. Some anti-epileptic drugs deplete the stores of folic acid so in general extra doses of folic acid seem to be a good thing, however large doses have been known to make the epilepsy worse.
  
  Herkes GK. Epilepsy. Med J Aust 2001 May 21;174(10):534-9
  
  "There is a slightly increased risk of congenital malformation associated with the antiepileptic drugs. Folic acid supplementation is advisable."
Mineral deficiencies to be aware of include:
- Di-methylglycine (DMG). This is another amino acid which has helped to bring people out of a seizure. It's function is to help move oxygen round the system.
- Iron - this can be a problem if the individual suffers from heavy periods or has digestive problems with frequent diarrhoea. Good sources of iron include red meat, eggs, sardines, dried fruit and nuts.
- Magnesium. Lack of magnesium causes irritability, nervousness and depression. In some cases injections of magnesium have stopped seizures to the point where drugs can be discontinued. Magnesium is found in dairy foods, meat and seafood.
- Manganese - there seems to be some evidence that a deficiency of manganese in the expectant mother's diet can cause congenital seizures. Manganese works with B vitamins to ensure a healthy nervous system, and is found in avocados, nuts, seeds, wholegrain products, egg yolks and pineapples.
- Taurine - this is an amino acid that helps inhibit neuronal activity. Some people with epilepsy have found that extra doses help control their seizures.
- Zinc - helps the immune system function, and a lack can cause problems such as mental lethargy and sluggish sex glands. It is found in pumpkin seeds, nuts, wholegrain oysters, brewer's yeast, egg yolks and poultry.
Research:

- Bac P, Herrenknecht C, Binet P, Durlach J. Audiogenic seizures in magnesium-deficient mice: effects of magnesium pyrrolidone-2-carboxylate, magnesium acetyltaurinate, magnesium chloride and vitamin B-6. Magnes Res 1993 Mar;6 1):11-9
"Magnesium deficiency in mice causes and increases audiogenic seizures... The results suggest that audiogenic seizures in magnesium-deficient mice form a model of magnesium depletion. This depletion is completely inhibited by the combination of an inhibitory neurotransmitter (taurine) and magnesium, in the form of magnesium acetyltaurinate."

- Tso EL, Barish RA Magnesium: clinical considerations J Emerg Med 1992 Nov-Dec;10(6):735-45
"Hypomagnesemia has been associated with a variety of disorders including seizures, malignant ventricular dysrhythmias, and sudden death."

- Prebble-JJ. J-Paediatr-Child-Health. 1995 Feb; 31(1): 54-6
"Primary hypomagnesaemia should be considered in infants with seizures, as failure to identify this metabolic disorder can result in death."

- De Vivo DC, Bohan TP, Coulter DL, Dreifuss FE, Greenwood RS, Nordli DR Jr, Shields WD, Stafstrom CE, Tein I. L-carnitine supplementation in childhood epilepsy: current perspectives. Epilepsia 1998 Nov;39(11):1216-25
"The panel recommended an oral L-carnitine dosage of 100 mg/kg/day, up to a maximum of 2 g/day. Intravenous supplementation for medical emergency situations usually exceeds this recommended dosage."

It is important to take advice when supplementing vitamins and minerals, as further imbalance may be detrimental to the health.

Other things to be aware of:

There is evidence that the build-up of various toxins from chemicals used in foods, pesticides and pollution have some part to play in epilepsy.
- Heavy-metal toxicity
  This has been especially singled out as playing a role in epilepsy. If heavy metal toxicity is a problem it can be dealt with by chelation therapy (see separate fact sheet). Tests to identify heavy metal toxicity can be undertaken at a number of laboratories. (See below for list of addresses.)
- Aluminium
  High levels of aluminium have been found in the brains of people with epilepsy. Studies in animals have shown that trace amounts of aluminium in the brain may initiate the type of disordered electrical activity that causes seizures.
- Aspartame
  According to research done by Arizona State University's Biochemical Department, the artificial sweetener Aspartame (NutraSweet) has been
  associated with seizures in some people.
- Food allergy and intolerance
  Genuine food allergy is rare but there is increasing evidence that intolerance to foods is rising rapidly. Elimination diets can help to identify which foods trigger seizures for a particular individual. An elimination diet starts by excluding all foods except those known to cause few allergies and then adding more foods one by one to see if a reaction occurs. If the individual has hayfever or eczema or other allergic illnesses it is especially worth exploring this possibility. The most common foods, which people are intolerant of are:
  - Aspartame
  - Citrus fruits
  - Eggs
  - Food additives and preservatives
  - Gluten, found in wheat, rye, barley, oats and buckwheat
  - Milk and dairy products
  - Peanuts
  - Shellfish
  - Strawberries
  - Sugar
  - Tap water
Psychotherapy and counselling
Both of these disciplines offer an individual the chance to talk through difficulties they are experiencing in their life, with the emphasis on learning new strategies to help manage the future differently. For people with epilepsy the talking therapies can offer an opportunity to learn how to manage stress, and to talk through their own feelings about living with the condition.

There are many different types of therapy available so it is a good idea to find out more about the different approaches before choosing a therapist.

For more information contact:

British Association for Counselling and Psychotherapy
1 Regent Place
Rugby
Warwickshire CV21 2PJ
Tel: 0870 443 5252
http://www.bac.co.uk/

Further reading: An Introduction to Counselling, John McLeod, Open University Press. A comprehensive introduction to the theory and practice of counselling and therapy, covering all of the core approaches.
Reflexology
Foot massage has been used for centuries as an aid to relaxation. Reflexologists,
however, go a step further, believing that the sole of the foot is covered with reflex points which relate to the rest of the body, so that the body can be treated by applying pressure and stimulation to particular points on the foot. Reflexology can be deeply relaxing for some people, so it could be of great use to those whose epilepsy is triggered by stress. However care needs to be taken as over-stimulation may trigger an attack. If using reflexology it is a good idea to consult a practitioner who understands epilepsy.

For further information contact:

Association of Reflexologists
27 Old Gloucester Street
London WC1N 3XX
Tel: 0870 567 3320
http://www.aor.org.uk

The British Reflexology Association
Monks Orchard
Whitbourne
Worcester WR6 5RB
Tel: 01886 821 207
Yoga
Yoga is a system of postures (asanas) and breathing (pranayama) that originated in India and is thousands of years old. In its purest form Yoga is a fully integrated system controlling all aspects of life, aiming towards spiritual enlightenment. In the West, however, it is more commonly used to increase suppleness and as a very effective relaxation technique. There are many different forms or schools of yoga. It is recommended that a qualified practitioner teach yoga and that the yoga student should aim to practice every day.

Yoga can help with epilepsy as breathing exercises can help to halt a seizure by focussing the mind on the breath. Yoga can also help to bring about a state of deep relaxation, which will help for stress-induced attacks.

Research:

- Yardi N. Yoga for control of epilepsy Seizure 2001 Jan;10(1):7-12
" There is a dearth of randomized, blinded, controlled studies related to yoga and seizure control. A multi-centre, cross-cultural, preferably blinded (difficult for yoga), well-randomized controlled trial, especially using a single yogic technique in a homogeneous population such as Juvenile myoclonic epilepsy is justified to find out how yoga affects seizure control and QOL of the person with epilepsy."

- Ramaratnam S, Sridharan K. Yoga for epilepsy. Cochrane Database Syst Rev 2000;(3):CD001524 "No reliable conclusions can be drawn regarding the efficacy of yoga as a treatment for epilepsy. Further studies are necessary to evaluate the efficacy of yoga in the treatment of epilepsy."

For further information contact:

The British Wheel of Yoga
25 Jermyn Street
Sleaford
Lincolnshire NG34 7RU
Tel: 01529 306 851
http://www.bwy.org.uk/

Yoga Therapy Centre
The Royal Homeopathic Hospital
60 Great Ormond Street
London WC1N 3HR
Tel: 020 7419 7195
http://www.freespace.virgin.net/yogabio.med/

4. Ketogenic diet

This is a medically supervised diet used in conjunction with, and sometimes as an alternative to, anti-epileptic medication. It has been available since the 1920's but has been less commonly used as an anti-epileptic medication improved. However there are some cases where these medications are poorly tolerated or are ineffective, and the diet may be of some use.

The diet was devised to mimic the effects of dehydration and starvation, both of which have been observed to help people with epilepsy, but which are obviously impossible to maintain. The diet is thought to work by encouraging the body to produce excess ketones, the presence of which chemical is thought to be responsible for its success. To encourage the production of ketones and mimic starvation, the diet needs to consist of 80% fat and 20% protein and carbohydrates, known as the diet prescription. Through this ratio the body is tricked into reacting as if it were starving, causing it to burn fats, not carbohydrates,
leaving a residue of ketone bodies, in a process known as ketosis.

The diet seems to be most effective for children between 2 and 12 years. Under 2 years the child cannot cope with such a high fat diet. However, as the child gets more independent it can be difficult to ensure the diet is adhered to rigidly, and so parents/carers must show a great deal of commitment in order for it to be successful. Adults have difficulty on the diet due to the problems of maintaining essential nutrients and finding the diet unpalatable.

It is important that the diet is followed under medical supervision and usually the individual is admitted to hospital to begin the diet with a 2 to 3 day fast, enabling the body to use up all the glucose in the blood. Complications may arise during this phase including weakness, dizziness, paleness, sweating and sleepiness. During the diet itself diarrhoea may occur, unpleasant breath, and occasionally a reduction in growth rate. The diet is individually tailored according to the individual's metabolic rate.

The diet is thought to have helped two thirds of children who have tried it, one third have found the diet controlling their epilepsy, and one third have had partial control. The remaining third have noticed no effect.

Medium-Chain Triglyceride (MCT)
Diet An alternative to the 'classic' ketogenic diet is the MCT diet that involves the use of a special oil (fractionated coconut oil) to attain ketosis. Although some find this diet is less unsettling and more flexible than the ketogenic diet, it is generally not as effective and less well tolerated.

Research:

- Schiff Y, Lerman-Sagie T. [Ketogenic diet--an alternative therapy for epilepsy in adults] Harefuah 1998 Apr 1;134(7):529-31, 591
" We recommend a therapeutic trial of the ketogenic diet in intractable epilepsy for all ages."

- Prasad AN, Stafstrom CF, Holmes GL. Alternative epilepsy therapies: the ketogenic diet, immunoglobulins, and steroids Epilepsia 1996;37 Suppl 1:S81-95
"Although the ketogenic diet, immunoglobulins, and steroids may have a role in the treatment of severe childhood epilepsy, all three therapies need to be critically evaluated in regard to efficacy, mechanism of action, and safety."

(See our fact sheet on the ketogenic diet for more information)

The Epilepsy Diet Treatment: An Introduction to the Ketogenic Diet by John M., Md Freeman, Millicent T. Kelly, Jennifer B. Freeman, John M. Freemen, available from www.amazon.com

Website: http://www.stanford.edu/group/ketodiet created by the Paediatric Neurology Division at Stanford University School of Medicine.

5. Seizure Alert Dogs

Operating on a similar principle to guide dogs for the blind, seizure alert dogs are trained to identify when their owner is about to have a seizure. Once warned the person affected can take measures to minimise risks to them during a seizure, e.g. lie down or remove dangerous objects from the vicinity. Another benefit of a seizure alert dog is that it allows the owner to relax in the knowledge that they won't be taken by surprise by a seizure, which may have the added benefit of reducing the number of seizures the person experiences.

No one is very sure how the dog is able to predict his or her owner's seizure. It may be through smell, the dog picking up chemical changes that take place in the owner before a seizure. It could be that the dog can detect subtle changes in the individual's electromagnetic field - it is thought that this becomes disrupted before a seizure. The third supposition is that the dog observes subtle behavioural and mood changes which occur in the individual before a seizure.

For further information contact:

Support Dogs (for seizure alert dogs)
The John Fisher Centre
Triaco House
Thorncliffe Park Estate
Chapeltown
Sheffield S35 2PH
Tel: 0114 257 7997
http://www.support-dogs.org.uk/

This is a registered charity. No charge is made to the person with epilepsy.

6. Self-help

There is a great deal of public ignorance about epilepsy and some people still believe that epilepsy is catching, or that those suffering from epilepsy have been taken over by the devil. Because of this general ignorance it can be quite difficult to discuss epilepsy openly, which compounds the ignorance of the public, and can leave the person with epilepsy feeling isolated and misunderstood.

Fear of the condition on the part of the person with epilepsy can often lead to unnecessary worry and feelings of isolation and low self-esteem. Children seem to deal with their epilepsy better if they feel that their worries about the condition will be treated seriously and their questions will be answered frankly.

It is important that the individual and their family, friends and peer group are well informed about their epilepsy and how to deal with attacks, should they happen. Families and friends also need support, as epilepsy is a condition that can be stressful for everyone in contact with it.

Epileptic attacks are often triggered by something in the environment, whether it is extreme weather conditions or high levels of stress. It is therefore helpful to keep a record of attacks in order to observe any patterns that exist. The diary should record where the attack happened, how long it lasted, the individual's emotional state before the attack, any unusual stimulus, etc. Information gathered over time will help the individual to recognise
triggers, and so be better able to avoid them.

Common triggers include:

Allergie
Boredom
Drugs - some may lower the seizure threshold
Emotional upset
Excess alcohol
Flashing lights
Illness
Irregular sleeping patterns
Lack of sleep
Low blood sugar (hypoglycaemia)
Menstruation
Nutrient shortages - B6, D, calcium and iron are among the elements blamed (see above for further details)
Sounds
Specific foods (depending on the individual - see above under food allergy and intolerance)
Specific smells (depending on the individual)
Stress
Strobe lights
Sudden extreme changes in temperature
Thundery weather due to increased electrical activity (although the trigger may actually be fear).
TV

To help avoid seizures it is important to:

Take medicine regularly - anti-epileptic drugs need to be maintained in the blood stream in order to be effective
Come off medication slowly - abruptly stopping a drug can lead to seizures.
Avoid using stimulants like caffeine, pseudoephedrine (found in decongestants), cocaine and marijuana (see above under cannabis).
Keep your doctor informed. Many prescription drugs lower seizure threshold so ensure that Doctors know that epilepsy is present and are aware of medication that is being taken before anything further is prescribed.
Be aware that alcohol can pose three threats: it speeds up the metabolism of the anti-epileptic drug, increasing risk of a seizure; it lowers the seizure threshold; and after drinking it is easier to forget to take the next dose of drugs.
Take moderate exercise to improve circulation to the brain.
Stay away from pesticides
Avoid using aluminium cookware, use glass or stainless steel instead. Aluminium can leach into the food during cooking and may contribute to seizures.
Consider having a hair analysis to rule out metal toxicity as the cause of seizures. (See below under laboratories).
Eat well and keep yourself in general good health by following a few general guidelines:
- Avoid any foods that you have identified as triggering a seizure: for common allergens see above under food allergies and intolerances.
- Avoid processed foods
- Avoid to much sugar and fat
- Eat a wide variety of foods
- Eat regularly - many people have low blood sugar at the time of a seizure
- Eat whole foods such as brown rice and wholemeal bread
- Include plenty of fruit and vegetables.

The Future of Epilepsy

The Montreal Neurological Institute leads the world in the field of neurosurgery, and is an internationally famous centre for epilepsy research. Subjects under research include:

Neural dysgenesis: a neural malformation which may happen as the embryo develops, meaning that some epilepsy may occur due to problems in the developing brain. If the reasons for this malformation can be identified, then prevention may be possible.
How seizures affect neurotransmitters: if it can be discovered how seizures affect neurotransmitters, it might be possible to create drugs which work at transmitter level to halt seizure activity.
Neurotrophic factors: neurotrophins are proteins that help nuerons to grow and survive, too few or too many can be harmful. The aim of the research is to harness neurotrophins to treat serious neurological diseases. This could be a possibility for treating brain damage associated with epilepsy.

References:
1. Statistics from the British Epilepsy Association
2. Nutritional Influences on Illness, Melvyn R Werbach, MD.
3. The Natural Way to Health: Epilepsy, Fiona Marshall
4. Epilepsy foundation fact sheet @ http://www.epilepsyfoundation.org/answerplace/surgery/benefitsrisks.html
5. Health Options, Complementary Therapies for Cerebral Palsy and Related Conditions,
Andrew Vickers.
6. The Natural Way to Health: Epilepsy: Fiona Marshall
7. Ibid
8. Taken from website: http://www.epilepsyontario.org/faqs/alternatives/magstim.html
9. Encyclopaedia of Complementary medicine, Anne Woodham and Dr David Peters
10. Complementary/Alternative Medicine - an evidence-based approach, John W Spencer,
PhD, Joseph J Jacobs, MD, MBA.
11. Prescription for Nutritional Healing, James F. Balch, M.D. and Phyllis A. Balch, C.N.C
12. Ibid
13. Ibid
14. The Natural Way to Health: Epilepsy, Fiona Marshall

Epilepsy Organisations

British Epilepsy Association
New Anstey House
Gateway Drive
Yeadon
Leeds LS19 7XY
Tel: 0113 210 8800
Helpline: 0808 800 5050 (9am to 4.30pm Mon to Thursday. 9am to 4pm on Friday)
http://www.epilepsy.org.uk
Offers information and advice as well as support through nearly 150 local groups

The National Society for Epilepsy (NSE)
Chesham Lane
Chalfont St Peter
Buckinghamshire, SL9 0RJ
Tel: 01494 601 300
Helpline: 01494 601 400 (Mon-Fri 1000-1600)
Website: http://www.epilepsynse.org.uk
Offers facilities for treatment and care of adults with epilepsy as in-patients and out-patients; diagnostic procedure to local GPs; rehabilitation unit; assessment unit affiliated to the National Hospital for Neurology and Neurosurgery; facts about Epileptic Surgery.

Epilepsy Foundation
4351 Garden City Drive
Landover
MD 20785 USA
Tel: (001) 301 459-3700
http://www.efa.org/

Brainwave - The Irish Epilepsy Association
249 Crumlin Road
Dublin 15
Tel: (00 353 1) 455 7500 (Mon-Fri 0915-1700)
http://www.epilepsy.ie/
Provides information, literature, counselling, support and advocacy.

The Epilepsy Association of Scotland
48 Govan Road
Glasgow G51 1JL
Tel: 0141 427 4911
Helpline: 0141 427 5225 (Mon-Fri 0900-1630)
http://www.epilepsyscotland.org.uk
Provides information, literature, support and advocacy for people with epilepsy throughout Scotland.

Epilepsy Bereaved
P.O. Box 1777
Bournemouth BH5 1YR
Support line: 01235 772852 (24 hr answering service)
http://www.bodley.ox.ac.uk/external/epilepsy/
Support for people bereaved by epilepsy.

Epilepsy Wales
15 Charter Street
St Asaph
Denbighshire LL17 0RE
Helpline: 0845 741 3774 (Mon-Fri 0900-1700)
http://www.epilepsy-wales.co.uk
Helping people throughout Wales who have epilepsy, their families and carers.

Joint Epilepsy Council
PO Box 27027
Edinburgh EH10 5YN
Tel: 0131 466 7155 (Mon-Fri 0900-1700)
http://www.jointepilepsycouncil.org.uk/
For information on epilepsy organisations and services throughout the UK and Ireland.

The Epilepsy Foundation of Victoria
818 Burke Road
Camberwell 3124
Australia
Tel: 03 9805-9111
http://www.epinet.org.au/

New York Hospital - Cornell Medical Center
Comprehensive Epilepsy Center
Room K619 - 6th Floor
525 East 68th Street
New York
N.Y. 10021
USA
Tel: (001) 212 746-2359
http://www.nypneuro.com/healthinfo/epilep.html
The following two organisations may be able to give help and information about a number of different therapies.

Institute for Complementary Medicine
PO Box 194
London SE16 7QZ
Tel: 020 7237 5165
http://www.icmedicine.co.uk

Council for Complementary and Alternative Medicine (CCAM)
206 Latimer Road
London W10
Tel: 020 8735 0632

Laboratories

The following laboratories provide mail order services. Please note that you may be requested to provide a letter from your doctor.

Biolab
The Stonehouse
9 Weymouth Street
London W1W 6DB
Tel: 020 7636 5959
http://www.biolab.co.uk

Genesis Diagnostics Ltd
Eden Research Park
Henry Crabb Road
Littleport
Cambridgeshire CB6 1SE
Tel: 01353 862220
http://www.gemini.co.uk/biopates/co/genesis/genesis.html

Health Interlink Ltd
Interlink House
Unit B, Asfordby Business Park
Welby
Melton Mowbray
Leicestershire LE14 3JL
Tel: 01664 810011
Health Interlink represents The Great Plains Laboratory, The Great Smokies Diagnostic Laboratory and Antibody Assay Laboratory in Europe

The Great Plains Laboratory
11813 West 77th
Lenexa, KS66214
Tel: (001) 913 341 8949
http://www.greatplainslaboratory.com

The Great Smokies Diagnostic Laboratory
63 Zillicoa Street
Asheville, NC 2880
Tel: (001) 800 522 4762
http://www.gsdl.com

Carbon Based Corporation
Five Osprey Drive
Suite 9
Millville NJ 08332
Tel: 001 609 825 8333

Websites

http://www.urmc.rochester.edu/strong/epilepsy/cepquest.htm
- University of Rochester Epilepsy Centre

http://www.epileptics.com
- Neurological Centre, Westmead, Australia

http://www.epilepsy.org.uk/info/parntfrm.html
- parents' guide to epilepsy

http://www.fit-and-well.co.uk
- Details and information to help sufferers cope with epilepsy.

http://www.datasync.com/~josw/epilepsy.htm
- database including making contact with other families dealing with epilepsy

SMEI / Dravet Syndrome

There is an international website for parents of children with Dravet Syndrome, an epilepsy syndrome which develops in infants under 1 year. It is severe and causes learning difficulties as well as seizures. As the website contains information about children, it is available by subscription only. Please contact by e-mail: SMEI-subscribe@yahoogroups.com

Alex's and my story

Alex was born with rare genitic disorder called Pelizaeus-Merzbacher Syndrome were it affects his nervis system nd their are 4 type and he has the READ MORE...

Kathleen's Struggle

Kathleen did not move much in utero. The doctors forecasted that she would probably have a cleft lip. Further tests didn't clearly indicate READ MORE...