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Zhu Z, Dluzynski D, Hammad N, Pugalenthi D, Walser SA, Mittal R, Samanta D, Brown ML, Asadi-Pooya AA, Kakooza-Mwesige A, Spalice A, Capponi M, Lekoubou A, Kumar A, Paudel S, Carney PR, Mainali G, Naik S. Use of Integrative, Complementary, and Alternative Medicine in Children with Epilepsy: A Global Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:713. [PMID: 37189961 PMCID: PMC10136598 DOI: 10.3390/children10040713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/23/2023] [Accepted: 04/06/2023] [Indexed: 05/17/2023]
Abstract
(1) Background: Epilepsy is one of the most common chronic neurological disorders in childhood. Complementary and alternative medicine (CAM) use is highly prevalent in patients with epilepsy. Despite CAM's widespread and increasing popularity, its prevalence, forms, perceived benefits, and potential risks in pediatric epilepsy are rarely explored. (2) Methods: We performed a scoping review of the available literature on the use of CAM in pediatric epilepsy. (3) Results: Overall, global cross-sectional studies showed a variable degree of CAM usage among children with epilepsy, ranging from 13 to 44% in prevalence. Popular types of CAMs reported were supplements, cannabis products, aromatherapy, herbal remedies, dietary therapy, massage therapy, and prayer. Families often report that CAM is effective, although there are limited objective measures of this. Potential risks lie in the use of CAM, such as herbal remedies, and/or unregulated, contaminated, or unpurified products. Studies also underscored inadequate patient-physician discussions regarding CAM. (4) Conclusions: A better understanding of this topic would aid clinicians in guiding patients/families on the use of CAM. Further studies on the efficacy of the different types of CAM used, as well as potential side effects and drug interactions are needed.
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Affiliation(s)
- Zahra Zhu
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
| | - Daniela Dluzynski
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
| | - Nouran Hammad
- School of Medicine, Jordan University of Science and Technology, Al-Ramtha 3030, Jordan
| | - Deepika Pugalenthi
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
| | - Sarah A. Walser
- Department of Psychiatry, Johns Hopkins Hospital, Baltimore, MD 21287, USA
| | - Rea Mittal
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
| | - Debopam Samanta
- Section of Child Neurology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Melanie L. Brown
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Ali A. Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz 71437, Iran
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Angelina Kakooza-Mwesige
- Department of Pediatrics & Child Health, Makerere University College of Health Sciences, Kampala 7062, Uganda
| | - Alberto Spalice
- Department of Maternal Sciences, University la Sapienza, 00185 Roma, Italy
| | - Martina Capponi
- Department of Maternal Sciences, University la Sapienza, 00185 Roma, Italy
| | - Alain Lekoubou
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
- Department of Neurology, Hershey Medical Center, Penn State University, Hershey, PA 17033, USA
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA 17033, USA
| | - Ashutosh Kumar
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
- Department of Pediatrics and Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Sita Paudel
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
- Department of Pediatrics and Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Paul R. Carney
- Pediatric Neurology Division, University of Missouri Health Care, Columbia, MO 65212, USA
| | - Gayatra Mainali
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
- Department of Pediatrics and Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Sunil Naik
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
- Department of Pediatrics and Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
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Asadi-Pooya AA, Brigo F, Lattanzi S, Karakis I, Asadollahi M, Trinka E, Talaat El Ghoneimy L, Pretorius C, Contreras G, Daza-Restrepo A, Valente K, D'Alessio L, Turuspekova ST, Aljandeel G, Khachatryan S, Ashkanani A, Tomson T, Kutlubaev M, Guekht A, Alsaadi T, Calle-Lopez Y, Mesraoua B, Ríos-Pohl L, Al-Asmi A, Villanueva V, Igwe SC, Kissani N, Jusupova A. Complementary and alternative medicine in epilepsy: A global survey of physicians' opinions. Epilepsy Behav 2021; 117:107835. [PMID: 33611098 DOI: 10.1016/j.yebeh.2021.107835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/25/2020] [Accepted: 01/30/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To investigate the opinions of physicians on the use of complementary and alternative medicine (CAM) in patients with epilepsy (PWE) worldwide. METHODS Online survey addressed to neurologists and psychiatrists from different countries. RESULTS Totally, 1112 physicians from 25 countries (different world region: Europe, North America, South America, Middle-East, Africa, Former Soviet Union Republics) participated; 804 (72.3%) believed that CAM might be helpful in PWE. The most commonly endorsed CAM included meditation (41%) and yoga (39%). Female sex, psychiatry specialization, and working in North and South America were associated with the belief that CAM is helpful in PWE. Two-hundred and forty five out of 1098 participants (22.3%) used/prescribed CAM to PWE; among them, 174 (71%) people perceived CAM to be less effective and 114 (46.5%) people found CAM to be safer than conventional antiseizure medications (ASMs). The most common reasons to prescribe CAM for PWE were: to satisfy the patient (49.9%), dissatisfaction with the efficacy (35.6%), and dissatisfaction with the adverse effects (31.2%) of conventional therapies. CONCLUSION Although the evidence supporting the use of CAM for the treatment of epilepsy is extremely sparse, most physicians worldwide believe that it could be integrated with the use of conventional ASMs, at least in some patients. High-quality controlled trials are warranted to provide robust evidence on the usefulness of CAM options in PWE.
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Affiliation(s)
- Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Francesco Brigo
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano-Meran, Italy
| | - Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Ioannis Karakis
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Eugen Trinka
- Department of Neurology, Christian-Doppler Medical Centre, Paracelsus Medical University, 5020 Salzburg, Austria; Institute of Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria; Centre for Cognitive Neuroscience, 5020 Salzburg, Austria, Associated Member of the European Reference Network EpiCARE
| | | | - Chrisma Pretorius
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Guilca Contreras
- Department of Pediatric Neurology, Hospital Metropolitano, Quito, Ecuador
| | | | - Kette Valente
- Laboratory of Clinical Neurophysiology, Deparment of Psychiatry, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil
| | - Luciana D'Alessio
- Buenos Aires University, Epilepsy Center, Ramos Mejía and El Cruce Hospitals, IBCN-CONICET, Buenos Aires, Argentina
| | - Saule T Turuspekova
- Department of Nervous Diseases with a Course of Neurosurgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Ghaieb Aljandeel
- Iraqi Council for Medical Specializations, Faculty of Epileptology, Medical City, Baghdad, Iraq
| | - Samson Khachatryan
- Department of Neurology and Neurosurgery, National Institute of Health, Yerevan, Armenia
| | | | - Torbjörn Tomson
- Department of Clinical Nueroscience, Karolinska institutet, Stockholm, Sweden
| | - Mansur Kutlubaev
- Department of Neurology, Bashkir State Medical University, Ufa, Russia
| | - Alla Guekht
- Moscow Research and Clinical Center for Neurospychiatry; Department of Neurology, Nerosurgery and Medical Genetics, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Taoufik Alsaadi
- Deptartment of Neurology, American Center for Psychiatry and Neurology, Dubai, United Arab Emirates
| | - Yamile Calle-Lopez
- Neurology Section, University of Antioquia, Fundación Clínica del Norte-Neuroclínica, Medellín, Colombia
| | - Boulenouar Mesraoua
- Neurosciences Department, Hamad Medical Corporation and Weill Cornell Medical College, Doha, Qatar
| | | | - Abdullah Al-Asmi
- Neurology Unit, Department of Medicine, College of Medicine and Health Sceinces, Sultan Qaboos University, Oman
| | - Vicente Villanueva
- Refractory Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Stanley C Igwe
- Department of NeuroPsychiatry, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Najib Kissani
- Laboratory of Clinical and Experimental Neuroscience, Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco; Department of Neurology, Teaching Hospital Mohammed VI, Marrakesh, Morocco
| | - Asel Jusupova
- Kyrgyz State Medical Academy, Neurology and Clinical Genetics Department, Bishkek, Kyrgyzstan
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Abstract
Complementary and alternative medicine (CAM) has become much in vogue, and CAM practitioners have increased in tandem with this. The trend of using CAM for treating epilepsy does not differ from that in other medical conditions, with nearly one half of patients using CAM. In this article we review the major complementary and alternative medicines used for treatment of epilepsy. They include mind-body medicines such as reiki and yoga; biologic-based medicine such as herbal remedies, dietary supplements, and homeopathy; and manipulative-based medicine such as chiropractic. In the available literature, there is a sense of the merit of these therapies in epilepsy, but there is a paucity of research in these areas. Individualized therapies such as homeopathy and reiki cannot be compared with medicines in a conventional pharmaceutical model. Hence, many studies are inconclusive. In a science of double-blind, randomized controlled trials, appropriate designs and outcome measurements need to be tailored to CAM. This article explains the principles of the major CAM therapies in epilepsy, and discusses peer-reviewed literature where available. More effort needs to be put into future trials, with the assistance of qualified CAM professionals to ensure conformation to their therapeutic principles.
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