Seizures - Naturopathic Perspectives

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Background

What comes to mind when you hear the word “seizure?” Having a seizure and/or witnessing a seizure can be a scary event. When a seizure happens, the neurons in the brain excessively and abnormally fire anywhere from a few seconds to several minutes, which causes changes in bodily control, behavior, sensation, and perception. [1] Seizures can happen for a variety of reasons. Medical reasons for seizures include drug and alcohol withdrawal and/or overdose, electrolyte imbalances, highly elevated fevers, exposure to toxins and dangerous chemicals, and low blood glucose levels. [1,2]

Some individuals have a seizure disorder, known as epilepsy. Hippocrates was the first person to identify epilepsy as a disorder of the brain back in 400 B.C. [2] The physiology and/or structure of the brain of an individual with epilepsy will be abnormal. Epilepsy is diagnosed when an individual has two or more seizures of unexplainable medical origin. Seizures are categorized as epileptic or non-epileptic in origin. A key point to remember is not all seizures are a sign of epilepsy even though seizures are the primary sign of epilepsy. In other words, not all seizures are created equal. Let’s further discuss the pathophysiology, classification, and naturopathic treatments of seizures.

Pathophysiology

As previously mentioned, a seizure results when the neurons in the brain fire excessively and abnormally. Neurons are nerve cells in the brain, which communicate via membrane potential. Neuron membranes maintain a balance of ions who act as chemical messengers with positive or negative charges that cause electrical signals to be sent by the brain. A neuron is at rest when the internal charge is more negative than the external charge. A neuron is active when this balance changes, resulting in voluntary and involuntary movements, feelings, and behaviors. [1,2] What causes neurons to excessively or abnormally fire? The causes of seizures can be known or unknown, but involve an altering of the membrane potential of neurons causing them to be hypersensitive as a result of exposure to a certain trigger, which can be medical, environmental, and psychosocial. [1] Medical triggers for seizures include:

Environmental triggers for seizures include:

• Strobe lights
• Repetitive or rhythmic music
• Excessively loud noises

Psychosocial triggers for seizures include:

• Emotional shock
• Major life events or stressors

Classification

Now that you understand the mechanics behind seizure activity, let’s further discuss how seizures can present or manifest. Seizures can originate from one point in the brain, called focal or partial seizures, or they can originate from many areas of the brain, called generalized seizures. [1,2] Focal, or partial, seizures are classified as simple or complex. Simple partial seizures include sensory perceptual changes and sometimes include convulsive jerking movements. Complex partial seizures include a loss in level of consciousness and convulsive jerking movements. [2] Generalized seizures are classified as absence, atonic (drop), clonic, myoclonic, tonic, or tonic-clonic. Absence seizures are uncommon and present as an absent stare typically in children without memory of the event occurring. Atonic, or drop, seizures occur when an individual suddenly falls down after the muscles of the body go limp. Clonic seizures involve repetitive jerking, or clonic, movements. Myoclonic seizures are milder versions of clonic seizures that present as a twitch or sudden jerk. Tonic seizures present as rigid stiffening of the muscles of the body, typically resulting in back arching, contraction of the extremities, and chest tightening. Finally, tonic-clonic seizures are a combination of jerking and stiffening movements of the muscles of the body often with a loss in level of consciousness and other bodily functions, such as bladder control. [2]

Naturopathic Treatments

The mainstay of modern treatment for the management of seizures and epilepsy has been anti-epileptic medication therapies. Seizure medications are prescribed with the common goals of reducing or eliminating seizures, providing an individual’s normal quality of life, minimize side effects of medication therapy, and maintaining work and personal activities and status. The type(s) of medication prescribed will be discussed with a qualified healthcare provider and consider a risk versus benefit analysis. Success of therapy depends upon starting treatment early in the course of diagnosis, finding the right combination, type of seizure(s) being treated, family history of seizures, and other co-morbidities. [2] Did you know 30% of patients will experience an adverse effect from anti-epileptic medication therapy? Some common adverse effects of seizure medications include fatigue, rash, dizziness, upset stomach, and blurred vision. [2] Each medication has its own specific set of potential adverse effects that should be considered and monitored when starting a new medication therapy regimen.

Finding the proper balance or prescription for managing seizures or epilepsy can be trial and error with first line agents used in singular or in combination with other medications. The accepted standard outcome of treatment with anti-epileptic medication is 50% of patients will have no seizures, 25% of patients will have reduced seizures, and 25% will see no change. [2] Other medications and vitamins used in conjunction with anti-epileptic medications include steroids, immunoglobulins, melatonin, and certain B vitamins (biotin, pyridoxine, folic acid). Individuals may also undergo recommended surgery to help with seizure control, including lesion removal, transections, or palliative surgery. [3]

With the potential for adverse effects of medication therapy and room for ineffectiveness, many patients and caregivers are seeking complementary and alternative therapies either in conjunction with or away from anti-epileptic medication therapy. Several basic lifestyle changes are helpful for lowering seizure threshold, including regular exercise, getting adequate sleep, and avoiding excessive alcohol intake. Other techniques and therapies can be utilized to help with seizure control, including psychological therapies, herbal medicine, homeopathy, aromatherapy, acupuncture, hypnosis, and service animals. Examples of psychological therapies include biofeedback, cognitive behavior therapy, relaxation techniques, and yoga. [3]

Cannabis and cannabidiol (CBD) oil have been topics of interest in the treatment of seizures and epilepsy. Cannabis, or marijuana, contains tetrahydrocannabinol (THC) plus CBD. Researchers have found the THC component to be associated with non-therapeutic effects, such as anxiety, paranoia, dry eyes, dry mouth, increased hunger, lethargy or anhedonia, and impaired memory. [4,5] These effects may also be positive for some individuals, such as cancer patients with a decreased appetite from chemotherapy. Medical researchers have found the CBD component of the marijuana plant to contain anticonvulsant properties, especially with children. [4] Different countries have different laws in place concerning cannabis and CBD. As always, be sure to protect yourself and know the legal classification of cannabis and/or CBD where you live.

Naturopathic doctors are poised to recommend dietary changes to patients with varying physiological conditions. A hot topic nutritional plan that has been referenced since Biblical times and used as a treatment for epilepsy in the pediatric population since the 1920’s is the ketogenic diet. [6,7] Other researchers have found the ketogenic diet to be effective in helping regulate seizures in adults as well. [7] The ketogenic diet has been shown to stabilize functioning of neuronal synapses, which increases the resistance or threshold to seizure activity. [7] A state of ketosis is achieved when dietary carbohydrates are dramatically dropped to less than 20 grams of net carbohydrates per day. Ketone bodies are used as fuel instead of glucose. Did you know diets high in sugar have been linked with a myriad of chronic diseases? [6] Dietary fat intake increases to about 70-75% of calories, whereas protein comprises 15-20%, and net carbohydrates comprise 5-10% of calories consumed. Grass-fed quality meats, organic eggs, full-fat dairy, certain nuts, berries, green leafy vegetables, low-starch vegetables, fats and oils, spices, and no sugar beverages are typically part of a ketogenic eating plan. Emphasis on food quality, such as locally-sourced, genetically-modified organism (GMO) free, allergen-free (dairy, gluten, soy, eggs, nuts), pesticide-free, and organic are key words to search for with nutritional quality. Beware of terms such as “all natural” or other misleading labels that have been coined in a practice called greenwashing.

In conclusion, seizures and epilepsy, a seizure disorder, are caused by abnormal misfiring of the neurons leading to behavioral changes. Causes of epileptic and non-epileptic seizures can be known or unknown. Medications have been commonly employed with a risk versus benefit approach and varying outcomes. Patients and caregivers have sought various alternative treatments, such as CBD oil and the ketogenic diet, to help with seizure control.