Epilepsy

What is Epilepsy?

Epilepsy is a long-term condition of the brain in which a person has repeated seizures caused by sudden abnormal electrical activity. It is one of the most common serious brain conditions, affecting over 70 million people worldwide.^[1]

Common symptoms

The main symptom is a seizure, and seizures look very different from person to person. Some cause a brief loss of awareness or an unusual sensation, while others cause stiffening and jerking of the body. A clear account from someone who saw the seizure is one of the most useful parts of the diagnosis.^[1]

Epilepsy also goes along with other health problems. Anxiety, depression and several other psychiatric conditions are more common in people with epilepsy than in people without it.^[2] Sleep problems such as insomnia are common too.^[3]

Causes and risk factors

Epilepsy has many causes and risk factors, and a strong genetic predisposition is part of the picture for many people.^[1] Brain injury, stroke, infection and structural changes in the brain can also play a part. The risk is highest in infants and in older people.^[1]

Stressful triggers such as infection, mental stress and sleep deprivation are important triggers of seizures in many people.^[4]

How it is diagnosed and treated conventionally

Diagnosis is clinical, based on the history and a witness account, with EEG and brain imaging used to find the type, cause and outlook.^[5]

Antiseizure medicines are the mainstay of treatment. They control seizures in about two thirds of people, but they do not change the underlying tendency to have seizures.^[5] For drug-resistant focal epilepsy, surgery can be effective in selected people. Nerve stimulation and dietary therapy are options when surgery is not suitable.^[5] Never stop or change these medicines without your neurologist.

Why Epilepsy calls for a whole-person approach

Seizures are a brain condition, and the medical treatment of them belongs to your neurologist. Living with epilepsy also involves sleep, stress, mood and day-to-day well-being, which is where supportive care may be useful.

These factors are linked to seizure control and quality of life, but this page does not claim that addressing them treats the epilepsy itself.

Stress

Mental stress is a recognized seizure trigger, and the body's stress-response system, the hypothalamic-pituitary-adrenal axis, appears to be involved in epilepsy.^[4]

Sleep

Seizures disrupt sleep, and poor sleep can in turn make seizures more likely. Insomnia and sleep apnea are the most common sleep disorders in people with epilepsy.^[3]

Mood and anxiety

A meta-analysis of 27 studies found that the odds of anxiety were about twice as high, and the odds of depression about two and a half times as high, in people with epilepsy compared with people without it.^[2]

Acupuncture as supportive care in Epilepsy

What the research shows

Acupuncture is not an established treatment for epilepsy. A Cochrane review of 17 trials with 1,538 people found that all had a high risk of bias and short follow-up, and concluded that the current evidence does not support acupuncture for treating epilepsy. It reported no excess adverse events with acupuncture in those trials.^[6]

Individual studies are mixed. A small trial in 34 people with drug-resistant epilepsy found no difference in quality of life between real and sham acupuncture over 8 weeks.^[7] A trial in 54 people with drug-resistant epilepsy found that thread-embedding acupuncture, a technique not offered at our clinic, produced more satisfactory seizure control than sham treatment. The authors called for longer follow-up.^[8] A review of complementary therapies used in China found the trials were small, short, varied and at high risk of bias.^[9]

For sleep and stress, a review noted that acupuncture and other complementary therapies may help by easing stress and seizure triggers. It also said that evidence-based data are still deficient.^[3] This is evidence about related symptoms, not proof that acupuncture helps epilepsy.

How acupuncture may work

A review of animal and clinical studies lists proposed effects of acupuncture on brain chemical messengers, ion channels and inflammation.^[9] These are proposed explanations, not settled facts.

What treatment involves

Treatment uses fine, sterile, single-use needles, usually left in place for about 20 to 40 minutes. We reassess after a short course of visits. We would aim sessions at relaxation, sleep and stress, not at seizures.

Serious problems from acupuncture are rare. In prospective studies about 9 in 100 patients had a minor reaction such as brief bleeding, soreness or redness at a needle site, and serious events occurred in about 1 in 10,000.^[10] Tell the practitioner about your epilepsy and seizure history, any seizure warning signs, and whether you have a bleeding disorder, take blood thinners, are pregnant, or have a pacemaker or a vagus nerve stimulator.

Ayurvedic medicine as supportive care in Epilepsy

The Ayurvedic view

Ayurveda relates epilepsy to Apasmara, described in the classical texts as brief unconsciousness caused by a disturbance of memory, intellect and mind.^[11] This is a traditional framework, not a biomedical diagnosis.

Therapies that may be used

Supportive care can include calming diet and daily routine, regular sleep hours, stress-reducing practices such as breathing and meditation, and gentle oil massage. Herbs are traditionally used for the mind and nervous system, including brahmi (Bacopa monnieri).^[12]

Panchakarma purification therapies are not appropriate during pregnancy, acute illness or frailty. They should not be used for epilepsy without your neurologist's knowledge, because fasting, sleep disruption and strong procedures could affect seizure control.

What the research shows

The research on Ayurveda for epilepsy is very limited. A 2024 review summarizing Ayurvedic approaches described the potential of the therapies but is a narrative summary, not a trial showing that they control seizures.^[11] We did not find controlled clinical trials of Ayurvedic treatment for epilepsy in people.

A review of research on curcumin from turmeric suggests a protective effect on seizures, but its abstract describes no clinical trials in people with epilepsy, so it cannot show that curcumin helps.^[13] Brahmi is traditionally used for epilepsy, and a StatPearls overview describes clinical studies of it on learning, memory and anxiety, not on seizures.^[12]

Herbal medicine as supportive care in Epilepsy

Herbs and formulas that have been studied

Many Chinese herbal formulas have been tested as add-ons to antiseizure medicines or as alternatives to them. A review lists herbs thought to act through anti-inflammatory, antioxidant and nerve-signaling effects.^[14] A systematic review of herbs used for seizures in Asia, Africa and Latin America found that the most commonly used species were not the ones that had been tested pharmacologically.^[15]

What the research shows

Herbal medicine is not an established treatment for epilepsy. A Cochrane review of 5 short trials with 1,125 people found all were of poor quality and concluded that the evidence is insufficient to support traditional Chinese medicine for epilepsy.^[16]

A later meta-analysis of 20 trials with 1,830 people with drug-resistant epilepsy found that adding Chinese herbal medicine to antiseizure drugs was linked to fewer seizures each month. Most trials had poor methodological quality, and the authors said the findings must be interpreted with care.^[17]

Safety and herb-drug interactions

Herbs can interact with antiseizure medicines. A review of herb-drug interactions found that anticonvulsants were among the drug classes with the most reported herb interactions, and that liver enzymes that process drugs were also commonly involved.^[18] Piperine from black and long pepper increased blood levels of phenytoin in healthy volunteers, and St John's wort lowered levels of many medicines.^[19]

Because of this, no herb should be started without your neurologist's knowledge. In one study, about one fifth of Ayurvedic products bought online contained detectable lead, mercury or arsenic.^[20] Herbs should come from tested sources. Tell us if you are pregnant or breastfeeding or have liver or kidney disease.

Translating traditional medicine into modern biological language

The links drawn here are interpretation, not equivalence. Chinese medicine often describes seizure disorders in terms of wind and phlegm disturbing the mind, and Ayurveda describes Apasmara as a disorder of the mind and memory. Researchers studying these therapies look at nerve signaling, ion channels, inflammation and the stress response.^{[4, 9]}

No study has shown that these traditional patterns correspond to a specific biological process in epilepsy.

How this care fits with your medical care

Epilepsy needs to be managed by a physician, usually a neurologist. For a condition like this, we ask that you are under a physician's care for it and that your treating team knows you are receiving complementary care.

Keep taking your antiseizure medicines exactly as prescribed, and do not stop or change them. We do not diagnose or manage epilepsy or adjust medicine. Please bring your diagnosis, a full list of medicines and supplements, recent test results and any seizure triggers you know of.

When to seek urgent medical care

Some seizures are medical emergencies.

• A seizure that lasts more than 5 minutes, or seizures that follow one another without recovery
• A first-ever seizure
• Trouble breathing, or not waking up normally after a seizure
• An injury, such as a head injury, during a seizure
• A seizure during pregnancy, or in someone with diabetes
• A seizure in water

If any of these occur, call 911 or go to the nearest emergency department.