Can Complementary Therapy Make The Difference?

Complementary and alternative medicine is being seen by some in the field of western medicine, including some physicians who treat people with epilepsy, as something to look at for possible additional treatment.

Posted: January 1, 2002

Alternative medicine. Just saying those two words to some people conjures up images of early 20th Century trickery - the traveling medicine man with all of his tonics, cures and remedies. On the other hand, there are some people who feel that everything, which is labeled "natural," is safe and effective.

At the start of this century, complementary and alternative medicine is being seen by some in the field of western medicine, including some physicians who treat people with epilepsy, as something to look at for possible additional treatment.

Three Day Seminar

Complementary and alternative therapies for epilepsy were the topic of a recent three-day course at New York University School of Medicine in New York City. The seminar was conducted by fight against childhood epilepsy & seizures (f.a.c.e.s.) and co-sponsored by the Epilepsy Foundation, the American Epilepsy Society, the Epilepsy Institute, NYU and the Epilepsy Foundation's of New York City, Northeastern New York, Long Island, Rochester-Syracuse-Binghamton, Southern New York and Western New York. Topics focused on treatments for epilepsy that fall outside traditional western medicine.

Primarily aimed at patients and their family members, the course consisted of sessions to discover different types of treatments and their effects, how the therapy might blend together with epilepsy medications, as well as an afternoon of workshops to provide patients additional opportunities to discuss complementary treatments with course speakers.

Many Patients Can Benefit

During the opening session, Orrin Devinsky, M.D., professor of Neurology, Neurosurgery and Psychiatry at NYU School of Medicine and director of the NYU-Mount Sinai Comprehensive Epilepsy Center, spoke briefly to the more than 200 people gathered for the conference. He said there are many approaches to complementary and alternative therapies and that many patients benefit from the additional treatments.

Alternative therapies can include anything from aromatherapy to yoga, pet therapy to magnetic stimulation, or acupuncture to herbs.

Speakers at the conference were drawn from local university medical centers - New York University Hospital, Columbia, and the State University of New York, Brooklyn - and from others around the country and from overseas.

Several speakers from the United Kingdom attended the meeting. Peter Fenwick, M.D., Tim Betts, FRCPsych and Professor Stephen Brown spoke on self-generation of seizures, aromatherapy and hypnosis and pet therapy respectively. Professor Michael Trimble described magnetic stimulation and its use in epilepsy treatment.

Eastern Medicine Discussed

Eastern medicine and its traditional approaches to epilepsy were represented on the program by a number of speakers, including scientists from India and China.

Karl Nakken, M.D., Ph.D., who described use of acupuncture in epilepsy; Shaobai Wang, Lac., MD, who spoke of the role of Chinese herbal remedies, Satish Jain, M.D., DM, who talked about the Indian discipline of Ayurveda and epilepsy, and K. Deepak, M.D., Ph.D., who presented his findings on use of meditation in treatment of epilepsy.

The role of chiropractic techniques, yoga, and music therapy shared the podium with an update on the ketogenic diet, hormonal therapy, exercise and art therapy.

No Replacement for AEDs

Several speakers emphasized that the activities they were describing were not designed to take the place of generally accepted treatments such as use of antiepileptic drugs, but to supplement them and add whatever additional benefit a person might experience.

Brian Gleberzon, D.C., of the Canadian Memorial Chiropractic College of Canada, made a similar point during his presentation. If someone is interested in trying chiropractic medicine for epilepsy, that person should not stop seeing a neurologist or stop the medications that have been prescribed, he said.

Some form of spinal manipulation, combined with stretches and exercise, lifestyle and nutrition changes and a review of ergonomic influences are usually what are tried, he said. For epilepsy, most chiropractors would do adjustments to the neck and upper cervical spine.

"Chiropractic works for low back pain and some headaches," he said. "But unfortunately the profession is not immune to lurid advertising and doubtful claims." He emphasized that he was not promoting chiropractic as an epilepsy treatment, and that there had been no clinical trials on its effects. However, some case studies were positive, and it might be of benefit to some patients.

Alan Jacobs, M.D., who is doing research on use of hormones in treating seizures, described how hormones and epilepsy interact.

"Estrogen lowers the seizure threshold in animals," he said, "and there are similar results in women." Progesterone, on the other hand, has an opposite effect and reduces epileptic discharges in the brain."

Low progesterone in women can add to anxiety and depression, he said.

Natural progesterone is now being tried as a treatment to prevent seizures in women, and the National Institute of Neurological Diseases and Stroke is supporting a study of the treatment at several medical centers around the country.

Carol Schramke, Ph.D., of Pennsylvania's Allegheny General Hospital, talked about the relationship between stress and seizures and ways in which stress might be relieved.

While stress is a normal part of life, she said, negative stress affects people with epilepsy more than others. Sources of stress in epilepsy include negative reactions of others, the perceived need for secrecy (the issue of whether or not to tell other people), opportunities or lack of it at school or work, and the stress of physical limitations that separate people with chronic illness.

Stress can be treated with medications, such as antidepressants, anti-anxiety drugs and sleep aids. Some antiepileptic drugs have a therapeutic effect on stress, Schramke said.

On the other hand, there are some ways to reduce or prevent stress by changing behavior. Schramke identified these as psychotherapy of various kinds, stress and anger management techniques, relaxation, life style changes, yoga, meditation and exercise.

First of its Kind

The New York conference is believed to be the first to address a variety of complimentary and alternative medical approaches to epilepsy. It did so, Devinsky said, because two thirds of Americans have used this type of medication, and people with epilepsy want to know more about it.

"The role of specific complementary and alternative medications require more study," he told the conference audience, composed primarily of patients and family members. "And it is likely that some will show benefit.

"More data is needed, physicians need to be more open minded, and the complementary and alternative medicines people need to be more open minded about science-based medicine.

"What we need is a partnership."

Editor's note: The organizers of the three-day conference are planning a book on alternative and complementary medicines and epilepsy, to include presentations from the meeting.