EPILEPSY-CAN IT BE CONTROLLED NATURALLY

One of the first rules in epilepsy is DON’T let anyone persuade you to stop your ant-epileptic medication without the support or supervision of your neurologist.

There are other things which can be done to improve seizures on a daily basis which are outlined below; most of which are well-known and advocated by most doctors. The first 3 on the list all relate to each other

1. Don’t become sleep deprived

2. Get 8 hours sleep a night

3. Develop a regular sleeping pattern

Late nights and abnormally early mornings are known triggers for seizures, so the development of a regular sleep pattern is paramount.

4. Eat regularly and don’t skip meals

Skipping meals can trigger seizures, so having 3 meals a day with a small healthy in-between meal snack is important.  For young ladies, pressure to maintain an ideal figure and bodyweight are immense, but it is better to have 3 small healthy meals than skipping meals….which could land you back in the Emergency Room being given more pills which have the side effect of making you eat all of your food and everyone else’s. So eat regularly, healthily and control the size of the portions. Work with a dietitian if necessary. Consider the Ketogenic Diet (see below) although it is not for weight loss and not for everyone.

6. Alcohol is your poison

Take alcohol very sparingly if going out with friends. Some people with epilepsy can tolerate alcohol, others have trouble. Drinking on an empty stomach is worse than drinking after a meal, so try to have some food first and minimize the number of drinks you have, and don’t stay out too late. (Always better to kiss and run and keep them wanting more, it makes a generally bad impression to be carted off to the Emergency Room at 4 am after half a dozen drinks and an E tablet and a highly embarrassing seizure putting you literally under the table thrashing at everyone’s shoes and crotches.)

For those who drink alcohol regularly, alcohol withdrawal also causes seizures.

7.”Other” medication should be taken with care. Other than your prescribed medication, be very careful what medication goes in your mouth. Some medication is known to increase the potential to have a seizure. Examples of these include the pain-reliever tramadol, antidepressants of the SSRI class, anti-smoking drug Zyban, combinations of tramadol and tricyclic antidepressants, weight loss drugs bupropion, and duromine. Hence the commencement of extra medication needs serious discussion with your doctor.

Street drugs should NEVER be taken. (Unless you want that 5am visit to the Emergency Room) Most illegal drugs, especially stimulants such as E, crystal meth, ice, cocaine, crack, PCP, amphetamines or and speed, cause seizures. Some of the impurities or additives to illegal drugs cause seizures, and illegal drugs may have unpredictable or dangerous interactions with prescription medicines. A definite prescription for Emergency Room visit.

8.  Women have extra problems with hormonal fluctuations. Some women can experience  an increase in seizure frequency before their monthly menstrual periods. Likewise some contraceptives cause problems in some women and not others. Some women are best avoiding the contraceptive pill altogether.

       9. Ask about an implanted vagus nerve stimulator as these are an available non-pharmacological treatment which can effectively reduce seizure frequency in many people.

1. Look into the Ketogenic Diet.  There is research supporting the use of the Ketogenic Diet for seizure reduction, but more controlled studies are needed. It appears to reduce seizure frequency even in refractory epilepsy if followed correctly. There is a high drop–out rate in studies testing the ketogenic diet because diets of any description are difficult to adhere to and require motivation. The ketogenic diet in its classic form of treatment gets 80 percent of its calories from fat. The rest comes from carbohydrates and protein. Each meal has about four times as much fat as protein or carbohydrate. The amounts of food and liquid at each meal have to be carefully worked out and weighed for each person. Studies have been conducted during which   daily seizure diaries were kept and measurements of the urinary ketenes were recorded. Blood studies were done monthly and resting energy expenditure (REE), substrate utilization; body composition and quality of life (QOL) were measured before and after intervention.

It is not known precisely why a diet that mimics starvation by burning fat for energy should prevent seizures, although this is being studied. Nor do they know why the same diet works for some and not for others.About a third of patients who try the ketogenic diet become seizure free, or almost seizure free. Another third improve but still have some seizures. The rest either do not respond at all or find it too hard to continue with the diet, either because of side effects or because they can't tolerate the food.A side benefit of the diet is that many parents report that their children are more alert and make more progress when on the diet, even if seizures continue. If the diet seems to be helping, doctors will usually prescribe it for about two years. Then, they may suggest that regular food is slowly introduced into the diet to see if the seizures can still be controlled, even with a normal diet..The diet lacks several important vitamins which have to be added through supplements. Sometimes high levels of fat build up in the blood, especially if a child has an inborn defect in his ability to process fat. This possibility can lead to serious effects, which is another reason for careful monitoring.10. Manganese deficiency should be corrected if the level is low on hair mineral analysis (blood levels are not always reliable) as Mn deficiency is associate with seizures. The same applies to other known biochemical imbalances which trigger epilepsy including elevated calcium, low sodium and low glucose. REFERENCES

1: Seizure. 2008 Aug 1. [Pub ahead of print] Links

Ketogenic diet treatment in adults with refractory epilepsy: A prospective pilot study.

Mosek A, Natour H, Neufeld MY, Shiff Y, Vaisman N.

2: Rev Neurol. 1998 Jan;26(149):61-4. Links

[Ketogenic diet: efficacy and tolerability in childhood intractable epilepsy]

[Article in Spanish]

Caraballo R, Trípoli J, Escobal L, Cersósimo R, Tenembaum S, Palacios C, Fejerman N.

3: Epileptic Disorder. 2006 Jun; 8(2):151-5. Links

Ketogenic diet in patients with myoclonic-astatic epilepsy.

Caraballo RH, Cersósimo RO, Sakr D, Cresta A, Escobal N, Fejerman N.

Servicio de Neurología, Hospital de Pediatría "Prof Dr Juan P Garrahan", Buenos Aires, Argentina.

4. Epilepsy Res. 2002 Feb;48(3):221-7. Links

The ketogenic diet in children, adolescents and young adults with refractory epilepsy: an Italian multicentric experience.

Coppola G, Veggiotti P, Cusmai R, Bertoli S, Cardinali S, Dionisi-Vici C, Elia M, Lispi ML, Sarnelli C, Tagliabue A, Toraldo C, Pascotto A.

5: Epilepsia. 2007 Jan;48(1):82-8. Links

Safe and effective use of the ketogenic diet in children with epilepsy and mitochondrial respiratory chain complex defects.

Kang HC, Lee YM, Kim HD, Lee JS, Slama A.

Department of Pediatrics and Epilepsy Center, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

6.   Rev Neurol. 1998 Jan;26(149):61-4. Links

[Ketogenic diet: efficacy and tolerability in childhood intractable epilepsy]

[Article in Spanish]

Caraballo R, Trípoli J, Escobal L, Cersósimo R, Tenembaum S, Palacios C, Fejerman N.