Seizure disorders

Seizures occur when your brain cells, which communicate through electrical signals, send out abnormal signals. Types of seizures vary. Recurrent seizures from one of many chronic processes are considered epilepsy. However, seizures are not considered to be epilepsy if they occur only once or are correctable.

Signs and Symptoms

There are several types of seizures, each with its own symptoms. Seizures are usually classified as partial (involving a part of the brain) or generalized (involving most or all of the brain). Depending on the type of seizure, symptoms can include:

• Aura (before generalized seizures), including lethargy, depression, irritability, involuntary jerks of limbs, abdominal pains, pale complexion, headache, constipation, or diarrhea
• Loss of consciousness
• Falling down
• Staring during momentary episodes of unconsciousness
• Total body muscle spasms
• Temporary cessation of breathing
• Bluish color of skin and mucous membranes
• Dilated pupils that do not react to light
• Bowel or bladder incontinence
• Increased pulse and blood pressure
• Increased salivation and sweating
• Deep coma, post-seizure confusion, and deep sleep

What Causes It?

Seizures are caused by hyperexcitable nerve cells in the brain (cerebral cortex) that fire abnormally. No one knows why this happens. The conditions listed below are associated with seizure activity.

• Central nervous system infection (bacterial meningitis, encephalitis)
• Drug toxicity or withdrawal (for example, alcohol or illicit drug use)
• Genetic mutations
• Head trauma
• Electrolyte or metabolic abnormalities
• Drugs that lower the seizure threshold
• High fevers
• Brain abnormalities (for example, tumors, stroke)
• Low sugar and low calcium levels in the blood

What to Expect at Your Provider's Office

Precipitating events (for example, head trauma) and risk factors (for example, family or personal history of seizures) are important factors to be discussed with your health care provider. It is also important to note how you felt before and after the seizure. Your health care provider will do blood tests and an electroencephalogram (EEG) to help in your diagnosis. You may also have a computerized tomography (CT) scan and a magnetic resonance imaging (MRI) scan.

Treatment Options

The goal of therapy is to stop the seizures, minimize drug side effects, prevent recurrences, and help you readjust to your home life and work environment after a seizure.

Drug Therapies

Your health care provider will most likely prescribe medication to help control your seizures (30 - 70% of people who have one seizure will have a second seizure within 1 year). You may need to try several medications or combinations before you find one that works for you. Medications can include anticonvulsants (anti-seizure drugs) and sedatives.

If medications do not work, ask your doctor about a procedure called vagus nerve stimulation.

Complementary and Alternative Therapies

You should always see a doctor if you or your child has a seizure. Taking some supplements and adjusting one's diet may help some people lessen the frequency of seizures, but the same supplements may have the opposite effect in some people. You should never take any supplements without your doctor's knowledge. You should never taking any medication your doctor has prescribed without your doctor's knowledge, either. Make sure all of your health care providers know of any medications, herbs, supplements, and regimens you are using.

Nutrition and Supplements

• A ketogenic diet -- high in fat and low in protein and carbohydrates -- may help control the frequency of seizures. It has been used most frequently in children and seems to be more effective for children than adults. A doctor needs to closely monitor this diet, both for side effects and for compliance with its rigid structure.
• Some studies have shown a connection with food allergies and seizures in children. Avoid alcohol, caffeine, and aspartame, along with any supplements that have stimulating effects. A holistically oriented health care provider can help you pinpoint possible food allergies.
• Taurine (500 mg three times per day) is an amino acid that may help inhibit seizures. It acts in a similar fashion to GABA (gamma aminobutyric acid, 500 mg two times per day), another amino acid that is often low in people with seizures. Take one of these only under your doctor's supervision.
• Folic acid may be depleted during seizures and in some people with seizures. However, taking extra folic acid can reduce the effectiveness of anticonvulsant drugs and lead to more seizures. Take folic acid only under your doctor's supervision.
• Vitamin B12 (100 to 200 mcg per day): B12 levels may be reduced by some anticonvulsant drugs.
• Vitamin B6 (20 to 50 mg per kilogram of body weight) may help control seizures in children, but B6 may also interfere with anticonvulsant medications, leading to more seizures. Take only under your doctor's supervision.
• Vitamin E (400 IU per day) may help reduce the frequency of seizures when used with prescription drugs, but studies have shown mixed results.
• Manganese (5 mg per day) levels are often low in people with epilepsy.
• Anticonvulsant drugs may cause low levels of calcium, vitamin D, and vitamin K, so people who take anticonvulsant drugs should ask their doctor about taking a supplement. You should know that calcium can interfere with anticonvulsant drugs and should only be taken under a doctor's supervision.
• Melatonin (3 g at bedtime) may decrease the frequency of seizures in children, but also can increase seizures in some people. Take melatonin only under a doctor's supervision.
• 5-HTP can help increase serotonin levels in the brain, which some researchers think can lessen seizures by having a calming effect on the nervous system. Others feel that raising serotonin levels past a certain threshold may actually increase the frequency of seizures. While no conclusive studies exist, some doctors are using 5-HTP to treat seizures. This therapy should be used only under strict medical supervision. 5-HTP can have dangerous interactions with other medications, such as antidepressants and certain neurological drugs. Make sure your doctor has a complete list of your medications before starting you on 5-HTP therapy.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Many of the herbs used to treat seizures have sedative effects, and they interact with other herbs, supplements, and prescription medications. Take these herbs only under a doctor's supervision, so that they can monitor side effects and interactions. Most of these herbs have been used traditionally for seizures, but scientific evidence that they work is lacking.

• Brahmi (Bacopamonnieri), an herb used in Ayurvedic medicine to treat epilepsy.
• Chamomile (Matricaria recutita), a sedative herb. Take 400 - 1,600 mg per day or 3 cups tea per day. Steep 2 - 4 g flowerheads in one cup boiling water, strain, and cool. Or use commercially prepared tea bags. Your doctor should determine the dose.
• Kava (Piper methysticum) has been used as a sedative herb for seizures. However, there is some concern that kava can be very damaging to the liver even if taken for a short time. Take kava only under your doctor's supervision, so they can monitor liver function. Do not take kava if you have Parkinson's disease.
• Valerian (Valeriana officinalis, 120 mg three times per day) is a sedative and anticonvulsive. It interacts with several medications, herbs, and alcohol, so take it only under your doctor's supervision. Valerian is sometimes combined with lemon balm (Melissa officinalis), another herb with sedative effects.
• Passionflower (Passiflora incarnata) may treat and prevent seizures. Dose is 3 cups tea per day. Steep 2 g in one cup boiling water, strain, and cool. Or take 45 - 60 drops of liquid extract.

Avoid the following herbs:

• Ginkgo (Ginkgo biloba) and ginseng (Panax ginseng and Panax quinquefolius) have caused seizures in some people.
• There is some evidence that GLA, a type of fatty acid found in evening primrose oil (Oenothera biennis) and borage oil (borago officinalis), may worsen epilepsy, although it has not been confirmed.
• St. John's wort (Hypericum perforatum) interacts with a number of medications and herbs used to treat epilepsy.
• White willow (Salix alba) may interact with medications for epilepsy.

Avoid these essential oils: eucalyptus (Eucalyptus globulus), fennel (Foeniculum vulgare), hyssop (Hyssopus officinalis), pennyroyal (Mentha pulegium), rosemary (Rosmarinus officinalis), sage (Salvia officinalis), tansy (Tanacetum vulgare), thuja (Thuya occidentalis), and wormwood (Artemesia absinthium).

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend one or more of the following treatments for seizure disorders based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- their physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

• Belladonna -- for seizures that occur in individuals with a high fever
• Causticum -- for individuals whose seizures may be triggered by receiving bad news or by feelings of sadness such as from grief; this remedy is most appropriate for individuals who tend to feel hopeless and fearful
• Cicuta -- for individuals who develop seizures after a head injury
• Cuprum metallicum -- for individuals whose seizures are accompanied by mental dullness; may be triggered by menstruation or vomiting

Physical Medicine

Chiropractic, osteopathic, or naturopathic manipulation may be helpful, especially in children or for seizures after head trauma.

Acupuncture

Acupuncture may be helpful with specific acupressure points that have been used to stop seizures. However, a recent study for people with severe epilepsy showed no benefit. Chinese medical literature contains examples of treating seizure disorders, often seen as an imbalance of “wind,” through traditional acupuncture, as well as scalp and auricular (ear) acupuncture or a combination of all these techniques. If you choose to have acupuncture, work with a qualified acupuncturist and keep all of your other providers well-informed about your treatments.

Following Up

Determining the best dosage or drug combinations is an inexact science; your provider will monitor you until your seizures are under control.

Supporting Research

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