Epilepsy

Epilepsy is a brain disorder characterized by short, recurrent, periodic attacks of motor, sensory or psychological malfunction. These attacks, called epileptic seizures, are caused by the abnormal, synchronous electrical discharge of millions of neurons in the brain, perhaps resulting from abnormal reverberating circuits. The incidence of seizure disorders is about 2%, with about 0.5% of those suffering from epilepsy on a regular basis. At least four types of epileptic seizures have been identified: grand mal, temporal lobe, focal and petit mal. Grand mal (tonic-clonic seizure) is characterized by generalized involuntary muscular contraction and cessation of respiration followed by tonic and clonic spasms of the muscles. EEG recordings indicate a high voltage synchronous discharge that occurs over the entire cortex on both sides of the brain, originating in the basal regions of the brain that drive the cortex. The reticular activating system may be temporarily depressed so that the person loses consciousness. The teeth may be clenched, the tongue may be bitten and control of bowel and bladder may be lost. After the seizure consciousness shortly returns and breathing begins with noisy respirations. The person may feel sleepy, fall asleep or experience confusion and has no memory of the episode upon awakening. The prodromal symptoms of grand mal may include auras, as well as unusual odours and sounds. (Berkow 1992, 1439)

Temporal lobe (psychomotor seizure) is characterized by psychic symptoms (visual or auditory hallucination, déjà vu), loss of judgment and autonomic behaviour, and abnormal activity. Typically, there are no apparent convulsions, but there may be a loss of consciousness or amnesia for the episode. During the seizure the patient may appear drowsy, intoxicated, violent or commit asocial behaviours, but other activities such as driving a car or eating remain unaffected. Psychic symptoms may be accompanied by chest pain, transient respiratory arrest, tachycardia, abnormal taste and/or smell sensations, and GI disturbances. EEG readings during a psychomotor attack show a low frequency rectangular wave with a frequency of between 2 and 4 Hz, superimposed with 14 Hz waves. (Berkow 1992, 1439-40)

Focal epilepsy can involve almost any region of the brain, resulting from localized lesions such as a tumor or damaged neural tissue, or from congenitally deranged circuitry. Such lesions can promote the rapid discharge of local neurons, and when this electrical activity passes a threshold of about 1000 Hz, it begins to spreads to adjacent cortical regions, as slow as a few millimeters per second to as fast as a few centimeters per second. When such a wave progresses over the motor cortex, it often causes a progressive series of muscular contractions throughout the body, while the person remain conscious. It may begin in the fingers and toes and progress upwards, or it may begin in the mouth region and progress downward to the legs. This particular manifestation of progressive muscular contraction is called Jacksonian epilepsy. (Berkow 1992, 1437-40)

Petit mal (absence seizure) is characterized by a sudden momentary loss of consciousness (10-15 seconds), occasionally accompanied by myoclonus of the neck or upper extremities, slight symmetric twitching of the face or a loss of muscle tone. EEG recordings in petit mal show a characteristic spike and dome pattern. (Berkow 1992, 1438-40)

Brain samples from epileptic foci of experimental animals have been shown to have abnormally low concentrations of GABA and abnormally high levels of glutamate. Physiologically, the role of glutamate is excitatory, promoting neuronal firing in the cerebellum and depolarization in the cerebral cortex. GABA, on the other hand, inhibits cerebral firing. Administration of glutamate in experimental animals has been shown to induce epileptic seizures. Thus, excessive amounts of glutamate may be a mechanism of seizure. Seizures are believed to stop because of neuronal fatigue, and the active initiation of inhibitory neurons. (Cooper 1996)

Epileptic seizures are known to be initiated by strong emotional stimuli, alkalosis caused by hyperventilation, drugs (e.g. metrazol, insulin), fever, loud noises and flashing lights. Other possible causes of epilepsy include severe head injuries (even in gestation), atherosclerosis, brain tumors or abscesses, intracranial infection, drug abuse, cerebral ischemia, exposure to rapid fire images common to some kinds of television programming and video games, food allergies, and Leaky-Gut syndrome.

Many epileptics report an unusual odor prior to seizure, which may or may not be present in the environment. Neural pathways from the basal ganglia and many other brain regions extend into the olfactory bulb, and thus odor may be a trigger or a symptom for seizure. Some clinicians have speculated that it may be possible to prevent seizures by anticonvulsant essential oils such as Aniseed, Celery seed and Lavender. Some kinds of essential oils are reported to initiate seizures, such as Artemisia spp., and should be avoided.

Medical treatment of epilepsy

Medical treatment rests on the usage of a variety of anticonvulsant drugs that act in a variety of ways. Barbiturates such as phenobarbital and primidone depress excitatory postsynaptic discharges, thereby raising the convulsive threshold for electrochemical stimulation. Benzodiazepines such as clonazepam enhance the activity of GABA. Hydantoins such as phenytoin inhibit seizure activity by blocking the propagation of electrical impulses, through decreasing sodium transport or by blocking calcium channels. Other anticonvulsants such as valproic acid act as GABA agonists by inhibiting GABA metabolism and presynaptic uptake, and enhancing post-synaptic uptake. Surgical options in the treatment of epilepsy may consist of the removal of the corpus callosum, the hippocampi and other brain regions. Electroconvulsive therapy is another technique used to treat epilepsy.

Holistic treatment of epilepsy

When attempting to wean a patient off of anticonvulsants it is imperative that it is performed slowly, and only in mild to moderate cases. Treatment can be given with the anticonvulsant, as long as it doesn’t have a similar activity, such as using a GABA agonists like valproic acid with Valeriana spp. The use of botanical GABA agonists can be gradually increased as the medication is being weaned. This initial phase of botanical support that doesn’t directly interfere with the medication can occur over a one to three month period. Weaning is performed over a six month period, gradually reducing the dosage of the anticonvulsant, but depending upon the symptoms of the patient, the entire weaning process may actually occur a little faster. Regardless, at all time during the weaning process and for the length of the holistic treatment, the patient should keep his or her anticonvulsant medication on hand, and be directed to pay strict attention to prodromal symptoms such as headaches, visual disturbances, olfactory disturbances, odd sensations, or dizziness. When the weaning process is completed, the patient should be symptom free for at least two years before discontinuing the supporting therapy. Even if weaning is not attempted however, many of the recommendations below are useful.

Botanicals

• Anticonvulsants: Valeriana, Withania, Cimicifuga, Viscum, Acorus, Lobelia, Piper methysticum, Ruta, Tilia
  
• GABA agonists: Valeriana, Piper methysticum, Tilia, Withania, Passiflora
  
• Nervine trophorestoratives, to protect neurons: Centella, Bacopa, Acorus, Withania, Rosmarinus, Avena Hypericum, Ganoderma, Eleutherococcus, Turnera, Sida cordifolia, Phyllanthus emblica, Panax spp., Polygonum, Angelica sinensis, Cordyceps, Grifolia, Coriolus
  
• Antioxidant botanicals: Curcuma, Boswellia, Commiphora, Crataegus, Phyllanthus emblica, Bacopa, Tinospora, Shilajitu, Ginkgo, Rosmarinus, Centella, Silybum, Buplerum, Astragalus, Spirulina, Ganoderma
  
• Hepatics and aperients, to ensure the proper elimination wastes: Berberis, Rumex, Taraxacum, Rhamnus purshiana, Rheum, Operculina, Embelia
  

Supplements

• vitamin A, 10,000 IU daily
  
• vitamin B complex, 100 mg b.i.d.
  
• vitamin C, to bowel tolerance
  
• vitamin D3, 3000-5000 IU daily
• vitamin E, 800-1200 IU daily
  
• EPA/DHA, 1000 mg each daily
  
• calcium/magnesium, 1:1, 800 mg each b.i.d.
  
• chromium, 200 mcg t.i.d.
  
• selenium, 200 mcg b.i.d.
  
• zinc, 50 mg daily
  

Diet

• implement elimination-challenge diet
  
• emphasize antioxidant foods, e.g. garlic, onions, cruciferous vegetables; foods rich in anthocyanidins, e.g. blueberries, huckleberries, elderberries, red and black grapes
  
• avoid stimulating foods and beverages such as coffee, tea, aspartame and chocolate
  
• avoid refined foods such as sugar; implement a low-carb, ketogenic diet (see Paleolithic diet)
  

Aromatherapy

• lavender, celery seed, aniseed

Topical

• Balashvagandha taila in shirodhara
  
• cranial sacral therapy
  

Other

• ensure proper bowel elimination
  
• destress environment, biofeedback, massage
  
• lower exposure to high stimulatory media (e.g. video games) and emotionally disturbing stimuli (e.g. horror movies)