Epilepsy: Symptoms, Causes, Treatments, and Natural Approaches

About 3.4 million Americans have the neurological disorder. International Epilepsy Day is the second Monday each February (Feb. 12 this year).

Epilepsy is a condition wherein a person experiences recurrent seizures. Illustrations by The Epoch Times, Shutterstock

Epilepsy is a neurological disorder that results from abnormal electrical activity in the brain, leading to recurring seizures. These seizures impact an individual’s awareness, behavior, movements, and sensations. Epilepsy is one of the most common nervous system disorders, affecting people of all ages and ethnicities. Approximately 65 million individuals are affected by epilepsy globally.

What Are the Types of Epilepsy?

There are several kinds of epilepsies and hundreds of epilepsy syndromes. If a person’s type of epilepsy has a known cause, it is termed “symptomatic epilepsy.” Some syndromes seem hereditary or result from gene changes, while others have unknown causes. These syndromes are often characterized by their symptoms or the specific brain region of origin.

There are four main types of epilepsy:

• Generalized
• Focal
• Combined generalized and focal
• Unknown

Generalized

People with generalized epilepsy have the onset of electrical activity originating in both brain hemispheres. During such a seizure, awareness is impaired, and consciousness is lost. This type of seizure can be further classified as motor onset and nonmotor onset.

Motor seizures typically involve movements on both sides of the body. Identifying focal or generalized onset can be challenging when motor activity is limited or one-sided. The following are types of generalized motor seizures:

• Tonic-clonic seizures, previously known as grand mal seizures, involve crying out, loss of consciousness, falling to the ground, and experiencing muscle jerks or spasms on both sides of the body.
• Clonic seizures induce repetitive, rhythmic jerking motions, typically occurring in the arms, legs, or face.
• Tonic seizures involve overall stiffening without rhythmic jerking in all limbs. Typically, muscles abruptly become rigid in the back, arms, or legs, potentially leading to a fall.
• Atonic seizures involve sudden loss of muscle control and tone, and they may result in limpness, causing a fall or head drop.
• Myoclonic seizures are brief seizures lasting two seconds or less and induce sudden, short twitches or rhythmic jerks without stiffening, typically observed in the neck, shoulders, and upper arms.

One example of a generalized-onset nonmotor seizure is an absence seizure. Previously known as petit mal seizures, absence seizures induce a brief altered state of consciousness and staring, and they primarily affect children. Typically, the individual maintains posture, with possible rapid blinking and twitches in the mouth or face. A seizure lasts no more than 30 seconds, and the person may not remember the episode after it ends. Absence seizures, occurring several times a day, typically begin between ages 4 and 12.

In contrast to typical absence seizures, atypical absence seizures have longer duration, more pronounced jerking or automatic movements, and a less complete loss of awareness.

Focal (or Partial)

Formerly termed “partial seizures,” focal-onset seizures originate in a specific area of the brain, impacting the parts of the body controlled by that particular region. They begin in nerve networks within half of the brain (one hemisphere) and can also originate in subcortical structures. Additionally, they can spread across the entire brain. When an individual experiences a focal seizure, then followed by a generalized seizure, the person has what is called a secondary generalized seizure.

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Classified by the level of awareness the person maintains during the seizure, different types of focal-onset seizures include:

• Simple focal: Simple focal seizures are also sometimes called focal aware or partial seizures. During such a seizure, the patient stays awake and aware, with possibly impaired communication or responsiveness.
• Complex focal: This type is also sometimes called a psychomotor seizure or focal impaired awareness. During complex focal seizures, awareness may be partially retained or wholly lost, and communication or responsiveness may be impaired. The person will not recall the episode but may remember the feeling (aura) that it was going to happen.

Combined Generalized and Focal

If a person has both generalized and focal seizures, it is called combined generalized and focal epilepsy. These people may have certain types of seizures more often than others, and seizures can occur simultaneously or separately.

Unknown/Unclassifiable

Seizures are labeled as unknown-onset when there is no information about their origins. As more details become available, these seizures may be reclassified as either focal-onset or generalized-onset. They can also manifest as either motor or nonmotor.

What Are the Symptoms and Early Signs of Epilepsy?

Epilepsy symptoms (seizures) differ among individuals. While some experience simple staring spells, others may undergo violent shaking and loss of alertness (convulsion). The affected part of the brain determines the specific type of seizure. In most cases, each seizure resembles the one that occurred before it.

Early Signs

An aura can precede seizures, especially focal, and refers to the sensations patients experience as seizures begin. Auras may involve motor activity or sensory, autonomic, or psychic sensations, such as numbness, rising upper abdominal sensation, abnormal smells, fear, or déjà vu.

Common Signs and Symptoms

Common seizure warning signs and symptoms include:

• Gazing or staring
• Jerking in the arms or legs
• Body stiffness
• Loss of consciousness
• Breathing difficulties or cessation
• Loss of bowel or bladder control
• Abrupt falling without an apparent cause, particularly with a loss of consciousness
• Short periods of unresponsiveness to noise or words
• A look of confusion or disorientation
• Rhythmic nodding of the head in association with loss of awareness or consciousness
• Instances of rapid eye blinking and staring
• Epileptic spasms
• Brief muscle twitching
• Repeated automatic movements, such as clapping or chewing
• Changes in sensations or emotions
• Total absence of movement (behavior arrest)
• Cognitive impairment: Cognitive impairment is observed in 70 percent to 80 percent of epileptic patients. It can manifest as memory loss, cognitive slowing, and attention deficits.

What Causes Epilepsy?

The brain, consisting of billions of neurons, has distinct areas responsible for various functions. Communication between nerve cells occurs through electrical and chemical signals. During an epileptic seizure, these interactions temporarily become disrupted, causing specific or all areas of the brain to become excessively active, leading to a “storm in the brain.” This abnormal activity manifests in noticeable effects, such as body convulsions.

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Seizures occur when something makes neurons fire off signals uncontrollably, short-circuiting the brain. Illustrations by The Epoch Times, Shutterstock

While numerous underlying disease mechanisms can contribute to epilepsy, the cause of the condition remains unknown (idiopathic) in approximately 50 percent of cases worldwide. According to the Mayo Clinic, the other half of epilepsy cases can be linked to genetics, head trauma, infections, brain disturbances, or prenatal injuries.

Genetics

When genetics are involved, epilepsy may be inherited from parents or be associated with “de novo” (new) gene mutations without a known family link. Genetic alterations may be a significant factor in the onset of certain epilepsy types. Researchers have identified numerous genes associated with epilepsy, including proline-rich transmembrane protein 2 (PRRT2), MECP2, CHD2, and many others. However, epilepsy’s causes remain complex, involving multiple genes and additional environmental factors.

An epilepsy specialist can determine if your epilepsy might have a genetic basis and may recommend genetic testing as a result.

Seizure Triggers

Seizure triggers don’t cause epilepsy but can provoke seizures in susceptible individuals, including those already diagnosed with epilepsy and taking medication. They include:

• Flashing or bright lights: Strobe lights in nightclubs are one example.
• High fever: This is especially true for children.
• Lack of oxygen
• Lack of sleep
• Stress
• Menstruation: About 50 percent of women in their childbearing years with epilepsy experience a rise in seizures around their menstrual period, a phenomenon referred to as catamenial epilepsy. This is caused by hormonal changes associated with menstruation.
• Excessive stimulation: Examples include prolonged computer screen use or extended video game play.
• Alcohol consumption or withdrawal
• Hyperventilation
• Dehydration or skipping meals
• Certain medicines: Antidepressants, diphenhydramine, stimulants (e.g., cocaine and methamphetamine), tramadol, and isoniazid are the primary contributors to most drug-induced seizure cases.
• Exposure to toxins or poisons: Toxins and poisons may include lead, carbon monoxide, and illegal drugs.

Who Is at Risk of Epilepsy?

While certain factors can increase the risk of epilepsy, the disorder may still develop even in the absence of these risk factors. The factors that make someone more at risk of developing epilepsy include:

• Age: The onset of epilepsy may take place at any age but typically begins in childhood or older adults. Children are more likely to develop it than adults, and the reason for this higher risk remains unknown.
• Seizure history: Around 50 percent of those who have one seizure may have another. The likelihood of further seizures increases for those who have experienced a second seizure, with approximately 70 percent having another seizure within a few years.
• Family history: Epilepsy is associated with many genes.
• Substance abuse: This includes drug and alcohol abuse.
• Birth conditions: A premature birth or low birth weight puts one more at risk.
• Metabolic disorders: Metabolic disorders, including Wilson’s disease and mitochondrial disorders, can be inherited or acquired.
• Other mental disorders: Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent co-occurring disorder in children with epilepsy, and those with ADHD face an increased risk of seizures, with around 14 percent experiencing seizures. People with autism also have a higher prevalence of epilepsy, with reported rates of about 20 percent.
• Electrolyte imbalances: Examples include reduced blood sugar, blood calcium, and blood magnesium.
• Maternal drug use: This is the use of drugs by a child epilepsy patient’s mother during pregnancy.
• Brain issues: These may include tumors, dementia, stroke, hemorrhage, and malformed blood vessels. In adults over 35, stroke is a primary cause of epilepsy.
• Transient ischemic attack (TIA): A TIA is a brief interruption of blood flow to the brain, causing stroke-like symptoms that typically last for one to two hours.
• Alcohol withdrawal: Approximately one-third of individuals undergoing significant alcohol withdrawal may encounter alcohol withdrawal seizures. There is a potential for serious complications, including the development of status epilepticus, a potentially fatal neurological emergency.
• Trauma: Significant head injuries, such as from a car accident, can cause epilepsy
• Infections: Epilepsy can be due to brain abscess, viral encephalitis, HIV, meningitis, and certain parasitic infections.
• Prenatal injuries: If a mother is malnourished or the developing baby is deprived of oxygen somehow, epilepsy can result.
• Multiple sclerosis (MS): The approximate frequency of epilepsy among individuals with MS ranges from 2 percent to 5 percent. This is because, in MS, damage occurs in various brain regions, causing disruptions in signal transmission. The sclerosis (scar tissue) in MS lesions acts as a physical barrier, hindering the transmission of nerve signals along affected pathways.

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How Is Epilepsy Diagnosed?

If you suspect you’ve had a seizure, your doctor may refer you to a neurologist, a specialist in nervous system issues. The neurologist will inquire about your symptoms, medical history, and family health and conduct a physical examination with a focus on your brain and nervous system function. Other tests may include imaging, blood, and other tests.

Brain Activity and Imaging Tests

• Electroencephalogram (EEG) is a diagnostic test that measures brain wave activity to identify abnormalities and assess the potential effectiveness of anti-seizure drugs. Video monitoring is often used in combination with EEG.
• Stereoelectroencephalography (SEEG) involves surgically implanting electrodes to locate seizure origins, aiding in the assessment of epilepsy surgery candidacy.
• Magnetoencephalogram (MEG) measures magnetic signals from neurons, assisting surgeons in planning interventions while preserving normal brain function.
• CT and MRI scans can identify structural brain abnormalities such as tumors, while functional MRI (fMRI) locates normal brain activity and detects abnormalities in brain function.
• Positron emission tomography (PET) scans capture brain images, revealing areas with abnormal chemical activity.
• Single photon emission computed tomography (SPECT) is used to pinpoint focal seizure locations by comparing blood flow images during and between seizures.

Blood Tests

Blood tests can identify metabolic or genetic disorders contributing to seizures and screen for underlying health issues such as infections, lead poisoning, anemia, and diabetes, which may cause or trigger seizures. The following are the types of relevant blood tests:

• Complete blood count (CBC) is a blood test that measures the levels of white blood cells, red blood cells, and platelets in the blood.
• Blood sugar tests assess the level of glucose, a type of sugar, in a blood sample. It is performed in the case of new-onset seizures.
• Blood chemistry tests, also known as chemistry panels, evaluate various chemicals, including enzymes, electrolytes, fats, hormones, vitamins, and minerals, in a blood sample to assess the functioning of organs and detect abnormalities.

Other Tests

• Genetic testing can be a valuable tool in understanding the genetic basis of epilepsy in individuals and enabling accurate diagnosis and optimal medical management. Genetic testing is recommended for people with unexplained epilepsy, utilizing techniques like exome or genome sequencing or multigene panels as first-tier diagnostic tools.
• Toxicology screening can reveal the presence of poisons, illicit drugs, or other toxins.
• Lumbar puncture (spinal tap) can test for encephalitis and spinal meningitis.

What Are the Complications of Epilepsy?

The complications of epilepsy include:

• Difficulty learning: Around half of children with epilepsy experience some type of learning difficulty.
• Aspiration pneumonia: Aspiration pneumonia can develop when food or liquid is accidentally inhaled into the airways or lungs rather than being swallowed, which can occur during a seizure.
• Accidents and injuries: Injuries can result from falls, self-inflicted bites, or accidents such as driving or operating machinery during a seizure.
• Drowning: People with epilepsy face a significantly higher risk of drowning, estimated to be 15 to 19 times greater than that of the general population, as some remain in the water during a seizure. In one study, 44 percent of these deaths were unwitnessed drownings in the bathtub.
• Brain damage: Brain damage may be the result of prolonged and uncontrolled seizures.
• Premature death: Individuals with epilepsy face a mortality risk of up to three times higher than that of the general population, leading to an increased risk of premature death.
• Sudden unexplained death in epilepsy (SUDEP): SUDEP is a rare complication of epilepsy and happens more often in those with frequent seizures. Such deaths cannot be attributed to any identifiable causes. Research suggests an annual occurrence of approximately 1.16 cases of SUDEP for every 1,000 people with epilepsy. It typically occurs during sleep, particularly at night, and no proven preventive measures have been identified.
• Mood disorders: The connection between epilepsy and mood disorders (e.g., depression) has been recognized for over 2,000 years.
• Sleep problems: Epilepsy can exacerbate sleep difficulties and may intensify existing sleep disorders.
• Cognitive issues: For most people, especially those with infrequent seizures, epilepsy generally doesn’t cause significant cognitive issues. Individuals with primary generalized seizures are less likely to experience cognitive problems compared to those with focal-onset seizures. However, some may encounter memory, language, or other cognitive function challenges.
• Bone issues: People with epilepsy face an increased risk of developing osteoporosis and fractures. Studies indicate a connection between anti-seizure medications and the development of osteoporosis.
• Pregnancy issues: Pregnant women with epilepsy, when compared to those without, exhibit an increased risk of various complications, including preterm birth and stillbirth.

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What Are the Treatments for Epilepsy?

Although epilepsy is currently incurable, treatment to achieve seizure control is highly effective, and there are many options available. The treatment plan will be determined by the severity of a patient’s symptoms and their overall health and response to therapy.

For epilepsy cases with identifiable causes, the most effective treatment approach is to eliminate the underlying cause of the seizures.

Medication

If the causes cannot be corrected or identified, anti-seizure medications (ASMs) (aka anti-epileptic drugs or anticonvulsants) are often necessary, especially after a second seizure, since seizures are sometimes one-off occurrences. Anti-seizure medications are the most commonly used treatment for epilepsy.

Over 40 anti-seizure medications are available in different forms, including tablets, capsules, and liquids. They can lead to seizure resolution in up to 70 percent of epilepsy patients. One drug is often sufficient to control most seizures, as combining medications can intensify side effects. In some instances, however, combinations may be necessary for forms of epilepsy resistant to a single drug. Side effects are typically more pronounced when initiating a new medication but tend to improve with time.

It is crucial to adhere to the prescribed duration of anti-seizure medication. Premature discontinuation is a key factor in individuals previously free of seizures experiencing new seizures and may result in status epilepticus. After two seizure-free years on medication, a health care professional may recommend discontinuing the treatment.

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While some individuals remain seizure-free for years, even after discontinuing medication, others only experience seizure control while on medication. Unfortunately, approximately 30 percent of people with epilepsy continue to have regular seizures despite undergoing various forms of treatment.

There are two categories of anti-seizure drugs, though there is overlap:

• Narrow-spectrum ASMs target specific seizure types and include phenytoin, phenobarbital, carbamazepine, oxcarbazepine, gabapentin, pregabalin, lacosamide, and vigabatrin.
• Broad-spectrum ASMs are effective against a wide range of seizures, including generalized, focal, absence, and myoclonic. They include valproic acid, lamotrigine, topiramate, zonisamide, levetiracetam, clonazepam, and rufinamide.

ASMs may be approved for monotherapy or as adjunctive therapy. They can also affect blood counts and internal organs. In addition, the U.S. Food and Drug Administration (FDA) requires a suicide warning for all seizure medications, although the actual risk is low. However, patients need to report serious depressive or suicidal thoughts to their doctor. Since certain epilepsy medications can also cause birth defects, women planning pregnancy should inform their doctor to make necessary adjustments to their medications.

Epilepsy that persists despite a person attempting two or three ASMs is “medically refractory epilepsy.” For such patients, who account for up to 30 percent of epileptics, doctors may recommend surgery.

Surgery

Surgery for epilepsy aims to avoid essential brain areas related to speech, movement, sensation, and memory. While it can effectively reduce seizures, surgery carries risks, and success is not guaranteed. There is a potential for cognitive, personality changes, and physical disability as postoperative outcomes.

The different epilepsy surgery types are:

• Lobectomy (or more limited lesionectomy) is the most common epilepsy surgery and removes the seizure focus, the brain area where seizures originate. It’s also called focal resection. These may include what is called a keyhole surgery, which is minimally invasive and enables doctors to reach tumors and lesions through small incisions using an endoscope, a thin tube equipped with a light and camera.
• Multiple subpial transection is used when seizures originate in an irremovable part. It involves precise cuts to prevent seizure spread, thus preserving normal abilities by sparing unaffected brain areas.
• Corpus callosotomy severs the corpus callosum (a cluster of nerve fibers) between brain hemispheres. It’s conducted primarily on children with severe seizures spreading from one hemisphere to the other. Although it can effectively stop certain generalized seizures, it’s not suitable for focal seizures.
• Hemispherectomy and hemispherotomy remove half of the brain’s cortex (outer layer) and are primarily performed in children with medication-resistant seizures.
• Laser interstitial thermal therapy (LITT) is a minimally invasive procedure that delivers focused energy to the specific seizure focus. The energy is converted into thermal energy, effectively destroying the brain cells that contribute to the seizures.

Therapies With Devices

Certain therapies involving neurostimulation devices can be used to manage epilepsy, providing electrical stimulation to the brain with the aim of decreasing the frequency of seizures. They include the following:

• Vagus nerve stimulation entails surgically implanting a battery-powered vagus nerve stimulator under the chest skin with a wire extending to the nerve in the lower neck, delivering short bursts of electrical signals to the brain to prevent nerve cell overactivity.
• Deep brain stimulation involves implanting electrodes connected to a neurostimulator (i.e., pulse generator) to regulate electrical signals in specific brain areas to prevent seizures.
• Responsive stimulation uses an implanted device to detect impending seizures and administer interventions, such as electrical stimulation or fast-acting drugs, to prevent their occurrence.

How Does Mindset Affect Epilepsy?

While a person’s mindset may not directly cause or improve epilepsy, it can influence the person’s coping and experience of the condition. Mindset can affect individuals with epilepsy in several ways, including:

• Stress reduction and emotional well-being: Stress and emotional factors can act as seizure triggers for some epilepsy patients. High levels of stress, anxiety, or emotional distress may contribute to an increased risk of seizures. Therefore, having a positive mindset may reduce feelings of stress and anxiety, potentially reducing seizure recurrence.
• Effective coping: Positive coping strategies and a resilient mindset can help individuals better manage the challenges associated with epilepsy. Epilepsy patients predominantly use coping strategies centered around managing emotions, which a positive mindset may better support.
• Treatment adherence: Individuals who approach their epilepsy management with a proactive and optimistic mindset may be more likely to follow treatment plans and take prescribed medications.
• Improved quality of life: A positive mindset may enable the person to accept the current situation, seek effective coping methods, and keep an optimistic outlook on life, thus having a better quality of life.

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What Are the Natural Approaches to Epilepsy?

Natural remedies exist for treating epilepsy, but in many cases, their effectiveness needs clinical research confirmation. Therefore, before considering any, you must consult your doctor first.

Medicinal Herbs

Herbal medical traditions are practiced globally, with notable traditions in China, Iran, Europe, and the United States. Herbal medication is the most common form of complementary and alternative medicine (CAM). It is often used in developed countries for seizure control, alleviating complications from anti-seizure drugs, and promoting overall health. In developing countries, herbal therapies are frequently employed as substitutes for Western medicines and complementary treatments.

While herbal medicine is widely accepted and used in anti-epileptic treatment, there is a lack of solid evidence regarding the efficacy and toxicity of most herbs.

Medicinal herbs that may be used to treat epilepsy include:

• Lavandula officinalis: Commonly used in Iranian traditional medicine for epilepsy, this herb has shown anticonvulsant effects in animal models with seizures induced by pentylenetetrazol, a central nervous system stimulant.
• Zizyphus jujube: In traditional Indian medicine, Zizyphus jujube is used as an anticonvulsant. The hydroalcoholic extract from its fruit has demonstrated a reduction in pentylenetetrazol- and maximal-electroshock (MES)-induced seizures in rats.
• Reishi mushroom (Ganoderma lucidum): A popular traditional herbal medicine, Ganoderma lucidum spore has properties that may help with epilepsy. It appears to reduce certain expressions in the brain related to epilepsy while enhancing the expression of a protein called neurotrophin-4 in specific brain cells.
• Chinese red sage (Salvia miltiorrhiza): This traditional Chinese herbal medicine is used to treat epileptic seizures. The acetonic crude extracts from this herb have shown significant anticonvulsant efficacy in animal studies.
• Gladiolus dalenii: This traditional African herbal medicine exhibits strong anticonvulsant properties. Its extract modulates GABA receptors, effectively reducing pentylenetetrazol-induced seizures and significantly decreasing MES-induced seizures in animal models by prolonging sodium channel inactivation.

Nutritional Supplements

Many of the following supplements can be taken when you are on anti-seizure medications. However, you still need to talk to your doctor before taking them. They include:

• Vitamin B6: Vitamin B6 deficiency can contribute to persistent seizures in newborns and adults. Adult-onset seizures due to vitamin B6 deficiency may stem from various factors like inadequate diet, liver disease, pregnancy, or specific medications. An active form of vitamin B6, pyridoxal phosphate (PLP), serves as a crucial coenzyme vital for amino acid synthesis, metabolism, and neurotransmitter formation. Specifically, PLP is essential for the decarboxylation of glutamine into gamma-aminobutyric acid (GABA), a significant inhibitory neurotransmitter. A deficiency in PLP results in reduced GABA levels in the brain, increasing the risk of seizures.
• Vitamin D: Many people with epilepsy have low vitamin D levels. One study discovered that when the participating epilepsy patients were given vitamin D3 supplements, their seizure frequencies decreased significantly. The clinical trial showed a 40 percent reduction in seizures.
• Vitamin E: In a 2016 study, vitamin E supplementation might have reduced seizure frequency, potentially due to its antioxidant effects on brain cells.
• Omega-3 fatty acids: In a study with 60 children with ADHD and intractable epilepsy, participants who took omega-3 supplementation had a significant reduction in seizure frequency after six months compared to those taking placebos. A meta-analysis also indicated a positive impact of omega-3 supplementation on seizure frequency in adults and children.

Special Diets

Four alternative diets that may help manage epilepsy include:

• Keto diet: Some evidence suggests that seizures may be triggered by the brain’s need for energy derived from glucose, a type of sugar. A ketogenic diet is characterized by high fat, low carbohydrate, and sufficient protein intake, leading the body to produce ketones from the breakdown of body fat. Ketones are an alternative energy source to prevent the body from consuming glucose. Strict adherence to the diet is crucial to maintain ketosis and have sufficient nutrients. A potential side effect of this diet is an accumulation of uric acid in the blood, posing a risk of kidney stones. While the reasons for its effectiveness are not fully understood, it is known to be highly effective for some patients. If seizures have been effectively managed for a significant period, typically around two years, the doctor may propose discontinuing the diet.
• Modified Atkins diet (MAD): The modified Atkins diet is a less restrictive version of the traditional ketogenic diet. Unlike the latter, MAD does not impose fluid or calorie restrictions. While fats are encouraged, they are not precisely measured, and there are no restrictions on protein intake, with around 35 percent of calories coming from protein for MAD patients.
• Medium-chain triglyceride (MCT) diet: The MCT ketogenic diet incorporates a fat supplement composed solely of MCT fats, typically in the form of MCT oil. MCT fats can produce ketones more easily without requiring carnitine, reducing the need for total fat in the diet. This enables a higher inclusion of carbohydrates and protein, potentially benefiting cholesterol and triglyceride levels compared to a long-chain triglyceride (LCT) diet.
• Low-glycemic index treatment (LGIT): The LGIT diet restricts starchy and sugary carbohydrates while allowing 40 grams to 60 grams of low-glycemic carbs per day, providing about 60 percent of calories from fat. It is a less restrictive alternative to the classical ketogenic diet, with fewer side effects, though effectiveness may take a few months to assess. Potential side effects include constipation, changes in blood chemistry, and weight loss.

Several diets that don’t treat epilepsy but are beneficial to epilepsy patients include the Mediterranean diet, a low-carbohydrate diet that limits refined grains, processed foods, and added sugars. It can be a healthy dietary choice for people with epilepsy. Epilepsy has also been associated with food allergies, prompting individuals with refractory epilepsy to consider an “elimination diet” as a dietary approach.

Essential Oils

Essential oils (EOs) with anticonvulsant properties have been traditionally used in various cultures globally, particularly in the Middle East, India, China, and Brazil.

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According to one study, some EOs containing alpha-pinene and other monoterpenes, including Angelica archangelica, Nigella sativa, Lippia alba, and Gardenia lucida, demonstrate anticonvulsant effects in animal models. Asarone, a compound present in the rhizomes of Acorus and Asarum plants, has demonstrated positive effects in improving the latency and severity of pilocarpine-induced seizures with daily treatment. EOs extracted from Cymbopogon plants contain various compounds with anticonvulsive properties, such as citral, citronellol, and citronellal.

However, certain EOs, such as rosemary, sage, thuja, cedar, hyssop, eucalyptus, camphor, pennyroyal, fennel, and spike lavender, are not recommended, as they may increase the risk of seizures.

Music Therapy

Research proposes that listening to specific compositions by Mozart, particularly the K448 and K545 sonatas, may positively impact reducing seizures in individuals with epilepsy, a phenomenon referred to as the “Mozart effect.” One study observed a correlation between noninvasive musical stimulation and decreased intracranial aberrant electrical activity in individuals with refractory epilepsy. The authors believed that the musical structure defined by the sonata form might trigger positive emotional responses, which could be significant for anti-epileptic effects.

Acupuncture

Acupuncture is a therapeutic technique where fine needles are inserted into specific acupuncture points on the body, triggering the release of natural pain-relieving chemicals called endorphins, promoting a sense of well-being.

Clinical studies indicate that acupuncture has positive effects on various types of epilepsy, including absence seizures, febrile convulsions, generalized clonic-tonic seizures, and status epilepticus. It can improve EEG patterns, reduce seizure frequency, duration, and severity, and enhance functional recovery and quality of life.

Chiropractic Care

Chiropractic care is a form of complementary and alternative medicine focusing on musculoskeletal disorders, especially the spine. It may reduce seizure activity in pediatric epilepsy cases. A review of 17 case reports suggested that correcting vertebral subluxation (a purported misalignment of the vertebrae) through chiropractic care resulted in a decrease in seizures, suggesting it may be a nonpharmaceutical approach for pediatric epilepsy.

How Can I Prevent Epilepsy?

Approximately 25 percent of epilepsy cases are potentially avoidable through preventive measures, including:

• Reducing head injuries by minimizing falls, traffic accidents, and sports injuries. Use safety belts, child passenger seats, airbags, and motorcycle/bicycle helmets.
• Adequate prenatal care and perinatal care if you’re pregnant, which helps reduce infant epilepsy cases related to birth injuries.
• Preventing stroke-associated epilepsy. Doing so involves reducing cardiovascular risk factors, such as managing high blood pressure, diabetes, and obesity, and avoiding tobacco and excessive alcohol use.
• Addressing infections and eliminating parasites.
• Using fever-reducing medication in children to reduce the risk of febrile seizures.
• Avoiding seizure triggers, such as flashing lights, excessive alcohol, missing sleep or meals, and others.