Herbal Treatment of Epilepsy Phytotherapy

Daniel J. Luciano, MD and Marcello Spinella, PhD

Phytotherapy is a form of complementary and alternative medicine (CAM) that uses plants to treat diseases, including epilepsy. The World Health Organization (WHO) has estimated that 80% of the world population uses some form of herbal medication, and it is estimated that greater than 50% of the United States population uses herbs for medicinal purposes, at a cost greater than $3 billion annually. Herbs and other forms of alternative therapy are most commonly used for chronic disorders that may not respond ideally to conventional forms of therapy. In addition, many patients have become disillusioned with the Western model of medicine. They are concerned about the potential toxic side effects and cost of artificially produced medications and would prefer to use "natural" remedies.

Herbs have been popular in Europe for centuries and remain so today. They were also quite popular in American medicine until the twentieth century, when they were largely replaced by pharmaceuticals. In the United States and elsewhere, they remain a mainstay of treatment in the practice of homeopathy and naturopathy. They are still used extensively in many developing nations.

Recently, herbs were found in a pouch worn by a 5,200-year-old prehistoric frozen mummy ("Oetzi") found in Northern Italy; he is now on display in Bolzano, Italy. The first official compilation of herbal treatments was ordered by the King of Sumeria in 2000 b.c. and consisted of 250 substances. The ancient Greeks and Romans also produced written texts on herbal medicine, such as the Roman De Materia Medica from the first century a.d.

In early herbology, the principle of the Doctrine of Signatures was used. Under this principle, a heart-shaped leaf was used for heart disorders and red leaves were used for bleeding disorders. Of course, this involved a great deal of trial and error. Interestingly, many modern drugs were derived from plants that were used by the ancients. The word drug was derived from the old Dutch word drogge, meaning, "to dry." At least 30% of the pharmaceutical drugs currently in use may have some plant derivatives in them (1). For example, aspirin was derived from white willow bark, atropine from belladonna, digox-in from foxglove, ephedrine from ephedra, morphine from the poppy, and quinine from chinchona bark.

Commentary

Drs. Luciano and Spinella review herbal therapies for epilepsy. This review complements the previous chapter by Drs. Conry and Pearl. The two sets of authors take different approaches to this important area in complementary and alternative therapies for epilepsy. Whereas the previous chapter by Drs. Conry and Pearl takes a more scientific—What's the evidence?—viewpoint while simultaneously taking a hard look at toxicity data, in this chapter, Drs. Luciano and Spinella provide a comprehensive review of major herbal therapies, examining data for mechanisms of action based on animal or other studies, as well as efficacy in what are largely uncontrolled studies.

The result of these two chapters is a balanced view of herb use for epilepsy, given our current level of knowledge. It is both a frustrating and exciting area for epilepsy therapy. Several herbs are likely to modulate seizure activity and could, if well studied, provide help to many people with epilepsy. In some medical cultures, especially in Asia, herbs have been used continuously for millenia, and their experience could provide a valuable starting point for systematic study. The herbs that have been traditionally used or shown in animal or small human studies to have antiepileptic effects should undergo more rigorous study to examine their potential therapeutic and toxic effects. As highlighted in Chapter 17 on Traditional Chinese Medicine, Drs. Shaobai Wang and Yanmei Li give other examples of herbal preparations that show benefits in preliminary studies. Emerging research in this area will provide more definitive information on the benefits and risks of these therapies. We anxiously await the results!

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