One-third of those with epilepsy in the US, that’s around a million people, do not respond to treatment with any of the existing therapies. Luckily, the following seven natural strategies—which including dietary and lifestyle changes—hold promise for those who don’t respond to conventional drugs.
The ketogenic diet is the most ubiquitous of all epilepsy nutritional therapies. So much so, in fact, that Eric H.W. Kossoff, MD, associate director of the Pediatric Neurology Residency Program and assistant professor of Pediatrics and Neurology at Johns Hopkins in Baltimore, Maryland, considers it mainstream. “The diet was exclusively developed for epilepsy back in the 1920s when doctors learned fasting improved seizures,” he says, “so they created this diet to mimic starvation.” Kossoff says that from the 1930s to the mid ’90s, drugs took over, “but now the ketogenic diet is back and very popular around the world.”
It begins with a 24-hour fasting period to cleanse the system. After that you restrict carbohydrates and instead get most of your calories from fats. People on the diet usually eat 3 to 4 grams of fat for every 1 gram of carbohydrate and protein. Nutritionists and neurologists tweak meals to induce ketosis, a state in which the body burns stored fat for fuel. Doctors don’t know why ketosis reduces seizures, but it produces positive results for lots of people. According to Kossoff, one-half to two-thirds of those who try the ketogenic diet get some degree of relief, and about 55 percent of those who respond positively experience a greater than 50 percent reduction in their seizures.
Loosen Up to Low-Carb
To the relief of many a food-cop mom, the latest research indicates that perhaps an anti-epilepsy diet needn’t be so rigid. Kossoff, along with a team of neurologists at Johns Hopkins, is pioneering what he calls the modified Atkins diet. “I was working with families who were on the ketogenic diet for a long time and they were no longer weighing and measuring their food—they were just winging it,” he says. “They were eating more carbs and less fat than the ketogenic diet would allow, but it was still working.” That’s when he figured this less-intense alternative—a one-to-one ratio of fats to carbs and proteins—was worth further investigation. “Children and adults can be on this looser diet and still make ketones and have seizure control,” says Kossoff. “It’s the carb restriction that really makes it work.”
In addition to nutrition, physical activities that lowers stress levels may help reduce seizures, too. Steven Pacia, MD, associate professor in the Department of Neurology at the New York University School of Medicine as well as a neurologist and director of Clinical Neurophysiology at the NYU Medical Center’s Comprehensive Epilepsy Center, advocates yoga. “I believe yoga is a fantastic resource to reduce your stress levels,” he says, “and because stress clearly plays a role in seizures, I think that seizure reduction is an indirect effect of the practice.” He prescribes yoga to his patients and suggests a Hatha practice, at least three times a week, that focuses on gentle postures and slow deep breathing.
Pacia recommends aerobic exercise (anything that gets your heart pumping), as well—a minimum of three times a week, for 20 minutes a session—and similarly credits its positive effects to stress reduction. “Many neurologists discourage exercise because they’re afraid patients will have seizures,” he says. “However, just 10 percent of patients actually have exercise-induced seizures.” If you’re in that minority, monitor your activity level by not doing too much too quickly, and exercise with supervision in case you have a seizure. Also, check with your doctor before beginning any exercise program.
Calm Down with Botanicals
Supplementing with herbs and other minerals can complement conventional epilepsy care, especially when you choose stress-busting and sedative botanicals. A 2001 study found that kava, valerian, chamomile, and passionflower may improve the effects of anti-epileptic medications, increasing their sedative and cognitive effects. The study also offered some anecdotal observations that discourage the use of ephedra, caffeine, ginkgo, and ginseng because they may exacerbate seizures.
Means advises against kava, however, because of its possible ill effects on the liver, but says she often prescribes passionflower in her practice, especially for children, and additionally suggests supplementing with the amino acid taurine. “It’s a neuro-modulator and can quiet electrical activity in the brain,” she says. Kids tolerate this supplement—found naturally in meat and eggs—especially well.
Means also recommends taking magnesium, explaining, “It can calm the mind and the nervous system.” Foods high in magnesium include mushrooms, whole grains, and nuts.
Adopt a Dog Detective
Specially trained canine companions can recognize the onset of a seizure, especially in children, and alert the parents. “We can’t guarantee every dog will be able to do this, but it is our hope,” says Karen Shirk, founder of Xenia, Ohio-based 4 Paws for Ability, a nonprofit organization that trains seizure dogs. But even if the dog can’t predict a seizure, the child still benefits. “Kids naturally feel at ease when the dogs are around, and the animals foster an increase in independence,” says Shirk. This stress reduction may be why, anecdotally, these dogs act as a form of treatment. Shirk’s organization has placed about 30 seizure dogs to date and all of the parents have reported a reduction in their child’s medications as well as in their number of seizures.
Accept Helpful Feedback
In an attempt to diminish abnormal brain-wave activity and elevate the seizure threshold, biofeedback (sometimes referred to as neurofeedback) uses conditioning to help epilepsy patients. Although the practice has been around for many years, recent research indicates it’s still a viable treatment to reduce seizures.
Biofeedback for epilepsy uses EEG technology to look for abnormal brain waves and then teaches patients various techniques—using a game or puzzle perhaps—that will help them morph them back into a normal pattern. Over time, these exercises may reduce the number of seizures. Before starting, however, find a practitioner with relevant experience. The Biofeedback Certification Institute of America (www.bcia.org) certifies practitioners and offers advice on how to find a credentialed one in your area.
Master Your Destiny
A recent development in the alternative treatment of epilepsy includes examining the condition in terms of emotions, especially anger and fear. “Our goal is to discover where the problem is coming from in the brain and then find compensatory measures to treat it,” says Donna J. Andrews, PhD, director of the Andrews-Reiter Epilepsy Research Program in Santa Rosa, California.
According to her research, emotional overload triggered 65 percent of the seizures she studied. Andrews therefore uses counseling and relaxation techniques to help her patients recognize early signs of seizures (called auras) and change their behavior to modify the outcome.
Before You Stop Taking Your Meds, Ask Your Doc
What should you do before going off anti-seizure medications? “When I work with patients, I try to wean them down to just one or two of the drugs,” says Means. “But I don’t recommend completely going off seizure medication unless you haven’t had a seizure in a very, very long time.” And even then, the experts urge, only do so under the strict supervision of your health care practitioners.