Epilepsy and Seizure Disorders

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

New Understanding of Seizure Disorders: integrating acupuncture, diet, herbal and nutrient medicine to treat the disease, not just control it

With a widespread acknowledgement that the ketogenic diet (a high percentage of healthy fats and avoidance of simple carbohydrates) dramatically reduces seizure activity in a majority of patients, especially the substantial percentage of patients that find poor control of the disease with standard anti-seizure medications, or who can no longer tolerate the side effects, more and more patients are researching the new scientific studies that also confirm that specific inflammatory dysfunctions are associated with perhaps all seizure disorders. With this new research, Complementary and Integrative Medicine (CIM) physicians are finding increased interest in devising long term holistic treatment protocols that may actually treat the underlying disease mechanisms, not just block the manifestations of the disease, the neurological seizures. Long term use of anti-seizure medications is proven to result in quality of life issues, and reducing or eliminating the need for these medications is the best possible outcome. Outcome studies in standard medicine continue to note that anti-seizure drugs have not been sufficiently validated for common epilepsy syndromes in animal studies, and current drug protocols come with a high degree of speculative evidence, which is frustrating (PMID: 23909849). Integrating Complementary Medicine supported by sound research may reduce side effects of medications, help control the rate and intensity of seizures, aid recovery from seizures and decrease the perpetuating cycle of inflammatory dysfunction, help repair brain glial cells and neurons, and support a better neurohormonal and immunological homeostasis. The practice of Traditional Chinese Medicine (TCM), or the Licensed Acupuncturist and herbalist, is the ideal Complementary Medicine physician to integrate into the treatment team.

In 2008, the American Epilepsy Society printed a research study in its publication, Epilepsy Currents (2008 May; 8(3): 75-77), headed by Annamaria Vezzani PhD, and based on an array of current studies that confirmed the role of inflammatory dysfunction and the immune complement system in human temporal lobe epilepsy. Activation of particular complement proteins (C1q, C3, C4), especially in areas of neuronal cell loss, was found to contribute to a sustained inflammatory response that is thought to destabilize neuronal networks. While the causes of seizure disorders are varied, and still poorly understood, these studies indicate that inflammatory processes may contribute to lowered seizure thresholds as well as playing a role in the origin of epileptic disease and cell death. Inflammatory dysfunction may cause lowered thresholds to neuronal excitability and negatively affect glial support cell functions, and repeated trauma of seizure activity may stimulate more inflammatory dysfunction, creating a vicious cycle of pathology. As with all complex multifactorial pathologies, a comprehensive and holistic treatment strategy is needed to restore healthy homeostasis. An integration of both allopathic and holistic medicine over the long term is the sensible approach.

Greater understanding of inflammatory imbalance and dysfunction is leading to a more holistic approach in restoring immune homeostasis regulating inflammatory processes. The complement system is a mechanism of both the humoral and cellular immune systems, and includes a proteolytic cascade of chemical mediators. The C1q protein plays an important role in clearance of older cells that undergo programmed cell death, or apoptosis. If such complement proteins are expressed inappropriately, this may lead to tissue damage or cellular dysfunction. To protect against these unwanted effects of the complement system, the cells express a variety of regulatory protein inhibitors. The whole system must work properly to prevent complement harm, just as the inflammatory system must work properly to promote tissue repair rather than injury or irritation. There are a number of therapeutic aids to immune complement function, reduction of key inflammatory cytokines, clearing of oxidant stress, and aiding neuron membrane health and function available with Complementary Medicine. With more difficult pathologies, a more comprehensive and persistent treatment protocol is needed, and integration of Complementary Medicine in the form of acupuncture, herbal and nutrient medicine, and dietary protocols may be very important to the long-term health and quality of life in epileptic pathology.

The liver is the main source of complement proteins, but many cell types, such as monocytes, fibroblasts, epithelial, and endothelial cells, may also synthesize these proteins. Health and healthy function of these sources of complement proteins is thus important in the treatment of epilepsy. Certain immune mediators, or cytokines, may enhance excess synthesis of specific complement proteins in these tissues, including TNF-alpha, Interleukin-1beta (Il-1b), and interferon gamma (IFN-gamma). These cytokines are overexpressed in a number of neurological disorders, with TNF-alpha overexpressed in both the brain and cerebrospinal fluid of Parkinson's patients, associated with inflammatory demyelination and neurological deficits, and other neurological diseases. IL-1beta is a pro-inflammatory cytokine involved in immune defense against infection, transmigration of leukocytes (white blood cells) to counter pathogens, allergens, and parasites, and is found to be overexpressed in Alzheimer's disease. Interferon-gamma is tied to the pathogenesis of various neurological disorders, inducing excess breakdown of the amino acid tryptophan to produce an excess of neurotoxic quinolinic acid. All three of these cytokines are found to be overexpressed in epilepsy.

The complex cascade of chemical feedback in the complement immune system may be affected by strategies affecting all stages of this biofeedback system. This has been the strategy in Traditional Chinese Medicine for centuries, treating liver health, immune function, and neurotransmitter balance with herbal formulas and comprehensive acupuncture point prescriptions to decrease the frenquency and intensity of epileptic disorders. Modern research helps define this strategy more specifically, improving the strategies of past centuries (see links to research below in additional information). As the National Institutes of Health work on mapping the neurological effects of acupuncture point stimulation, and biochemical research elucidates the specific effects of herbal and nutrient chemicals on cytokines, neurotransmitters, cell receptors, etc., this presents the patient and their physicians with more concrete tools to devise a safe, effective and holistic treatment protocol that works over the long term to treat this difficult disease and improve quality of life. With all complex pathologies, Complementary Medicine provides additional treatment protocols to integrate with specific allopathic medicines to that a number of goals of therapy may be safely accomplished with a minimum of adverse side effects. All experts in the field of epilepsy agree that allopathic pharmaceutical medicines exert their anti-epileptic properties through only a few neurochemical mechanisms, while the array of neurochemical mechanisms of epilepsy are broad. Complementary Medicine provides the patient with a broader effect, providing hope that the defects inherent in the various types of epileptic disorders can be addressed over time, and potentially leading to dramatic reduction in the hyperexcitability of brain cells. Many epileptic patients are realizing that partial reduction of seizures with drug dependence alone is not the optimal outcome.

Not only chronic inflammatory dysfunction, but the health and function of the neuron membrane and glial support tissues has been found to be integral to the dynamics of seizure disorders. Increased study of the brain with advanced imagery and measurement in recent years has led to the adoption of theories that a number of central pathologies lie along a continuum of altered dynamics of the neuron membrane, including spreading depression and excitotoxicity. Achieving improved function and health of the neuron membrane has become an important consideration in a more holistic approach to decreasing seizure threshold. In 2014, experts at the University Paris Descartes, Charles University in Prague, and the University Pierre and Marie Curie, in Paris, France, and Prague, Czech Republic, published a report that the origins of the epileptic pathology, or ictogenesis, appears to involve abnormal GABA receptor activation with a chloride ion excess inside of neurons, and a transient increase in sodium ions outside the nerve cells (PMID: 25078502). In 2012, experts at the Toronto Western Research Institute, in Canada, concluded that the onset of seizure disorders appeared to be dominated by exhaustion of presynaptic release of GABA and unopposed glutamatergic responses (PMID: 22396423). Such research demonstrates that homeostasis of the GABA and glutamate receptor metabolism, as well as the balance of mineral electrolytes and mineral ion channels in nerve cell membranes are at the heart of the still poorly understood pathology of epilepsy. By improving the health of the brain, neural membranes, and bioavailabilty of GABA, an important neurotransmitter involved in controlling excitability of firing in the brain, with a holistic approach in treatment, the pathology may be reversed over time. Integration of sensible evidence-based treatment protocols in Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) is the way to achieve these goals.

Understanding Seizure Disorders

An epileptic seizure manifests in a variety of presentations, with a majority of seizures producing mild symptoms that often go unrecognized, and undiagnosed. The manifestation of symptoms may range from a brief impairment of consciousness (as in an absence seizure) to the full tonic-clonic seizure with uncontrolled motor activity and impairment of consciousness. Most of these seizures are preceded by a prodrome period of altered perception, and all of them involve increased brain activity, sometimes dramatically increased. Memory of the seizure almost never occurs. Seizure disorders may occur with high fevers or brain trauma, be linked to inheritable traits (about 40 percent), occur secondary to other diseases and metabolic derangements, be chemically induced, or may be a primary seizure disorder with no known cause (idiopathic). About half of all patients diagnosed with a seizure disorder show no apparent underlying causative factors. The physiological manifestation involves an abnormal neuronal firing with broad effects, including motor, sensory, behavioral and autonomic. Under the right conditions, anyone may experience a seizure, but the term epilepsy suggests an enduring alteration of brain function that makes this abnormal neuronal firing easier to trigger. A large number of neurons need to exhibit hyperexcitability in synchronization to produce a significant neuronal seizure. Epilepsy is not a single disease, but a heterogenous set of disorders with a variety of underlying causes, and pathophysiological dysfunctions. Epileptic seizures are broadly classified as to their primary site of origin and pattern of spreading in the brain, with focal, or partial, seizures, as well as generalized seizure patterns. Not only specific allopathic medicines to target single focal aspects of the disease, but holistic regimens to address the broad array of dysfunctions and neurodegenerative problems should be utilized. These protocols are integrative, not exclusive.

The hippocampus, located in the limbic system of the medial temporal lobe of the brain, is especially associated with epilepsy, and this type is called the temporal lobe epilepsy (TLE). The hippocampus is associated with spatial memory, short-term memory, and long-term memory, and contains a large percentage of glutamate generating neurons, which are especially susceptible to excitotoxicity. TLE is the most common type of adult epilepsy that is poorly controlled with antiepileptic, or anticonvulsant, medications, and has provided researchers with a general model for epileptic pathophysiology that may be more easily studied, both in animal research, and in autopsy analysis. In recent years, the model of neurohormonal immunobiology has again gained wide acceptance in scientific study of the brain. This more holistic view of human pathophysiology acknowledges that neurotransmitters, hormones and immune cytokines have the ability to excite or inhibit the same cell receptors. While this has prompted wide research into new allopathic drugs to target a greater variety of biochemical functions in the brain related to uncontrolled seizure activity, it also points to the need to restore normal homeostatic mechanisms to bring a variety of contributing factors back into line. In the study of TLE, researchers have identified how initiating events such as sustained fevers may promote sensitivity to inflammatory complement proteins, cytokines and other neurohormonal chemicals. Approximately 30-70 percent of individuals with temporal lobe epilepsy have a history of prolonged febrile seizures in childhood. The effects of prolonged fever in response to stress, inflammation or infection, and subsequent prolonged overexpression of key complement proteins and cytokines such as IL-1b, may be experienced without the obvious clinical manifestation of childhood seizure, and a variety of biochemical changes that result may be more important in determining future excitotoxicity than the damage caused by actual childhood seizures. In other words, the initiation of inflammatory dysfunction may create a cycle of increased susceptibility to triggers of neuroexcitotoxicity later in life. This may be also related to a number of genetic mutations that make some individuals more susceptible.

Such research points to the fact that there is no single explanation for future onset of epileptic seizures. Excitotoxicity is not required to generate future seizures, and other mechanisms have been uncovered to explain the pathology. Neither is cell death a strict requirement to determine future epileptic status. The findings of sustained inflammatory dysfunction is determined to contribute in a number of ways, though, lowering the threshold for neuronal excitability, impacting the regulation of programmed cell death, or apoptosis, affecting the blood brain barrier, and affecting the cell receptor functions and membrane ion channels. A June 5, 2012 article in the New York Times Health section, entitled New Epilepsy Tactic: Fight Inflammation, cites the work of Eleonora Aronica, a neuropathologist from the University of Amsterdam, Annamaria Vezzani, a neuroscientist at the Mario Negri Institute for Pharmacological Research in Milan, Italy, and Orrin Devinsky, director of the Comprehensive Epilepsy Center at New York University Langone Medical Center. These experts describe how research in the last few years clearly elucidates how inflammatory dysfunction affects glial support cells, and how the trauma of repeated seizures in turn produces further inflammatory dysfunction that may perpetuate a cycle of epileptic seizures. Therapy to correct these inflammatory dysfunctions could treat the epilepsy itself, not just control the seizures, as current drug therapies attempt. These experts also point out the dangers of adverse effects of pharmaceutical anti-inflammatory strategies, though. Dr. Tallie Z. Baram, of the University of California Irvine, an expert in epilepsy, points out that the enthusiasm for these new drug strategies must be tempered by the limitations of strong anti-inflammatory drugs, especially concerning side effects. Complementary Medicine, integrated into this strategy, may address side effects, provide anti-inflammatory and antioxidant effects, inhibit specific cytokines, aid neuronal membrane health and function, aid immunological health and complement expression, decrease excitotoxicity, and decrease stress. These comprehensive benefits added to pharmacological therapy come with no side effects, except better overall health and quality of life.

As scientific research continues to expand the complexity of the epileptic pathology, patients with epilepsy may, of course, feel discouraged in the quest for finding healthy medical protocols to potentially relieve or cure the disease. Understanding the key mechanisms of the epileptic seizure is important when devising a comprehensive treatment protocol that is still practical, and integrating Complementary Medicine, in the form of individualized treatment from a Licensed Acupuncturist and herbalist, is able to provide such a protocol that can be as simple or complex as each patient desires.

Excitotoxicity is the pathological process by which the nerve cells are damaged and destroyed by excessive stimulation. Neurotransmitters such as glutamate, and altered glutamate receptors, are highly implicated in excitotoxicity, especially NMDA (N-methyl-D-aspartate) receptors. Activation of NMDA glutamate receptors results in the opening of a nonselective ion channel that is voltage-dependent, where extracellular magnesium ions may create a channel block, allowing increased sodium and calcium ions into the cells, and potassium out, in a voltage-dependent manner. The NMDA receptors are particularly important in the hippocampus, a seat of memory and learning, and the focal area of the brain in temporal lobe epilepsy (TLE). These NMDA receptors require co-activation by two ligands (ion or molecule that binds to a metal ion to form a gate, or coordination complex), glutamate and glycine. Excitotoxicity, and glutamate receptors, are also implicated in the growing incidence of attention deficit and hyperactivity disorders and nocturnal bruxism, or teeth grinding, and excitotoxicity due to glutamate and glutamate receptor changes are implicated in Alzheimer's disease, acute effects of strokes, autism, and ALS. Glutamate is the most abundant excitatory neurotransmitter in the brain. Altered glutamate receptors are now common in the human organism due to a large variety of glutamates added to food to increase desire or appetite. Monosodium glutamate (MSG) was just the first of these popularly added chemicals created by the food industry, and negative reactivity to MSG is now well known, with many people avoiding what they perceive as the source, inexpensive Chinese restaurant food. What is not widely known is that the food industry has created thousands of variations that are added to foods to increase sales. This may be one reason why dietary changes in epilepsy have such a dramatic effect.

Glutamate also serves as the precursor for another modulating neurotransmitter highly implicated in seizures and epileptic pathology, GABA (gamma-aminobutyric acid). GABA is the chief inhibitory neurotransmitter in the brain. GABA is also directly responsible for the regulation of muscle tone and spasticity. GABA works by binding to membrane receptors to regulation ion channels, chiefly regulating the flow of negatively charged chloride ions and positively charged potassium ions across neuron membranes. GABA levels and glutamic acid decarboxylase (GAD) activity were found to be reduced in focal areas of the brain surgically removed from patients with intractable epilepsy, and also in the CSF (cerebrospinal fluids) of epileptic patients (De Deyn et al, 1990). In addition, several drugs that induce convulsions, such as penicillin, pilocarpine, and pentylenetetrazol, inhibit GABA synthesis. Drugs that increase the availability of GABA have been utilized to treat epileptic convulsions, although side effects of memory loss have discouraged use. GABA does not cross the blood-brain barrier, and so cannot be simply supplied to the brain, and glutamate, or glutamic acid also cannot be simply supplied with nutrient chemicals. To effect glutamate and GABA homeostasis, and excitotoxicity, a more complex protocol must be used, supplying the precursors to creation of these chemicals in the brain, and decreasing the altered glutamate receptors to normalize excitotoxicity. A combination of L-glutamine, the B3 niacin inositol hexacotinate, and the B6 chemical P5P is such a nutritional aid to glutamate bioavailability and GABA homeostasis. The essential amino acid L-Glutamine is also supportive of the glutathione metabolism (cellular detoxification and antioxidant), clearing of excess ammonia, aiding acid/base balance, and relieving stress. The nutrient taurine, a derivative of the amino acid cysteine, also has GABA-like activity, and aids antioxidation, membrane stabilization, and modulation of calcium signaling. As nutritional and herbal research progresses, a number of herbal and nutrient chemicals are being found to modulate these mechanisms of excitotoxicity to restore homeostasis. Of course, these effects are not immediate. Some persistence of treatment, and a more holistic treatment regimen is needed to achieve the desired effects in reduction of excitotoxicity. Of course, avoidance of industrial food chemicals, and altered glutamates is important in this equation.

Another important amino acid implicated in the pathology of seizure disorders is glycine. Like glutamine, glycine is an amino acid that also serves as a neurotransmitter, both excitatory and inhibitory, but in key areas of the brain, glycine exerts a profound inhibitory effect of excitotoxicity. Like GABA and glutamate, glycine does not easily penetrate the brain-blood barrier in circulation, and so cannot be used directly to quiet CNS excitability, or lack of control of excess neural firing. Research has been searching for a drug that would penetrate the blood-brain barrier and act on glycine receptors, and have combined a longstanding drug, valproic acid, with a glycine derivative, glycinamide, and called it valrocemide. The scientist who developed this novel anti-epileptic drug, Dr. Meir Bialer of the Hebrew University School of Pharmacy, in Israel, was a student of the pioneering biochemist Dr. Rafi Mechoulam, who first isolated an active chemical in marijuana, or Cannabis, THC (tetrahydrocannabinol), a phytohormone that acted strongly at endogenous cannabinoid receptors. In recent years, scientists in Israel have also noted the positive effects of various chemicals in Cannabis for the treatment of seizure disorders, and the important role of endocannabinoids in the brain to control excitotoxicity. In response to great clinical success with severe epileptic disorders intractable to medications, many states in the U.S. have passed laws allowing the medical use of the herbal cannabidiol (CBD) for the treatment of seizure disorders, and much research, some of which is cited below with links to studies, is now available. By adopting a more holistic and restorative approach to the seizure disorder syndrome, individuals will be able to achieve much better outcomes, and better quality of life.

Immunological effects cannot be understated as well. As the research cited above demonstrates, overexpression of key inflammatory cytokines and complement proteins are integral to most epileptic disorders. Autoantibodies to glutamic acid carboxylase (GAD) are linked to autoimmune disorders highly associated with epilepsy, such as stiff-man syndrome. Imbalances of catecholamine neurotransmitters are also tied to epileptic pathophysiology. Decreased levels of dopamine have been found in the epileptic foci of patients (Mori et al, 1987), and in research studies, dopamine agonists are found to alleviate seizures (Snead, 1995). Research suggests that decreased dopamine facilitates a lowering of the seizure threshold triggering. Imbalance of various catecholamines in the brain is tied to seizure threshold, with levels of adrenaline, cortisol, serotonin and dopamine affecting this parameter. Research into these mechanisms continues to produce useful data that may be utilized in the comprehensive treatment strategies of Complementary Medicine. The treatment protocols in Complementary Medicine, especially TCM (Traditional Chinese Medicine) are comprehensive, and may utilize all of these strategies at once.

Pharmacological approaches with antiepileptic drugs

Currently, there are 20 medications approved by the FDA for anticonvulsant therapy, and should be intelligently paired with a correctly diagnosed, or typed, epilepsy. Since anticonvulsant medications may have very negative long-term effects on quality of life, it is important that the right drug be used to treat specific types of epilepsy. Of course, this requires a thorough and intelligent diagnostic evaluation. The most classic antiepileptic drugs, Phenytoin (Dilantin) and Carbamazepine (Tegretol), work by inhibiting voltage-dependent sodium channels, and are more effective in preventing the classic tonic-clonic seizures. As neuronal membranes are depolarized, the influx of sodium ions into the neuronal cell increases the number of open sodium channels in the cell membrane, further exasperating the hyperexcitability. Both the balance of extracellular sodium ions and intracellular potassium ions, which are exchanged, and the cell membrane integrity are important in maintaining membrane homeostasis. Phenobarbital (Luminal) and sodium valproate (Epilim) are older anticonvulsant drugs. These drugs come with alarming side effects, need for strict serum level monitoring and dosage adjustment, and significant drug interactions. Newer drugs utilized in epileptic treatment include Gabapentin (Neurontin), Topiramate (Topomax), Lamotrigine (Lamictal), levetiracetam (Keppra), Oxcarazepine (Trileptal), and Zonisamide (Zonegran). There is a high degree of uncertainty about the risks versus benefits associated with individual drugs. High failure rates in monotherapy has led to the use of multiple drug regimens for a significant percentage of patients. Risks in pregnancy, especially with the older antiepileptic drugs are considerable.

The U.S. FDA states that about 20 percent of patients continue to have seizures despite using the best anticonvulsant therapy, and defines effective as achieving at least a 50 percent improvement in the rate of seizures in 50 percent of patients. Other countries report rates of failure of standard drug therapy of at least 30 percent. European surveys report that nearly 90 percent of patients report at least one significant side effect in treatment in standard therapy. Most side effects are dose-dependent. Utilizing Complementary Medicine may be important to increase treatment effectiveness, achieve the lowest effective dosage to minimize side effects, and to work in the long-term to reverse the underlying pathological problems, such as tissue sclerosis, chronic inflammatory dysfunction, complement immune dysfunction, and excitotoxicity.

The study of acupuncture in the treatment of epilepsy

Integration of acupuncture, herbal and nutrient medicine, or Complementary and Integrative Medicine (CIM/TCM), into the treatment protocol for Epilepsy, as well as proven dietary regimens, offers the patients a safe, proven, and effective way to achieve significant reduction in seizure activity with fewer pharmaceuticals, which come with long-term adverse health effects that are often devastating to the quality of life. In recent years, sound research with functional MRI and other brain imaging technology has demonstrated that acupuncture stimulation has a strong modulatory effect on the regulatory centers in the brain that are responsible for seizure activity, especially the amygdala, hippocampus and cingulate gyrus, aiding restoration of homeostatic controls. Recent research has also demonstrated that specific Chinese herbs used to treat seizure activity, such as Uncaria rhynchophylla (Gout teng), exert strong antioxidant and other neuroprotective effects to gradually restore the cells and membranes in the brain to health, reducing seizures gradually with prolonged use.

While there is a long history of clinical evaluation of the success of acupuncture in the decrease in severity and frequency of epileptic seizures, there has been very few randomized, controlled human trials (RCTs) to confirm this clinical evidence. The application of acupuncture stimulation is not expected to produce immediate and dramatic reduction of seizure activity, but more and more research in recent years is demonstrating how specific types of acupuncture and electroacupuncture stimulation does affect the brain, and provides an array of beneficial effects in the overall treatment protocol. A 2008 review of RCTs by the esteemed Cochrane Database Systems Review found just 11 small human trials to evaluate that utilized blinded randomization and comparison of effects to a supposed acupuncture placebo, sham treatment, antiepileptic drug, or no treatment. The results prior to 2008 did reveal success in these trials, but the evidence was not strong enough to fully support acupuncture as a proven primary treatment strategy. For instance, a human trial that compared standardized acupuncture to phenytoin showed that patients who received needle acupuncture appeared more likely to achieve 75 percent or greater reduction in seizure frequency than those taking phenytoin. Human trials in Norway and China found that children treated with both acupuncture and Chinese herbs achieved greater than 75 percent reduction in seizure frequency, and that this effect was better than the use of Chinese herbs alone. The difficulties of devising these RCTs with a supposed acupuncture placebo, or sham treatment, is well publicized currently, though, and no other manual therapy is held to this standard.

Other types of proof of acupuncture efficacy involve objective analysis of the specific biochemical effects of acupuncture and electroacupuncture, especially on laboratory animals, and this type of study shows much proof of positive contribution of acupuncture to the treatment protocols needed to address the many factors in the epileptic disorder. These studies are increasingly showing reduction in seizure frequency as well, and have the added benefit of elucidating the mechanisms of benefit with blood analysis and autopsy dissection. A number of these studies are cited below in additional information. The focus of recent research is not to address a binary outcome of acupuncture versus pharmaceutical treatment, but to show how integration of these therapies holds much promise. The integration of a comprehensive treatment protocol is also very important to outcomes. By utilizing proven dietary protocols, herbal and nutrient medicines, and acupuncture stimulation guided by research, the overall effects, integrated with standard therapy, will prove to move the patient to a healthier state as well as better decrease the frequency and intensity of seizures. The promise of Complementary Medicine is the long term improvement in brain health and function and a better future outcome. The failures for many with drug protocols alone, and the gradually decreased quality of life is making the integration of Complementary Medicine more and more attractive to patients and their families.

Modern medicine has also experimented with techniques similar to acupuncture and electroacupuncture stimulation in the treatment of epileptic seizures. By 2013, clinics in major hospitals are offering transcutaneous vagal nerve stimulation (tVNS), which was introduced in the 1990s, but showed varied effects in reduction of seizure activity, sometimes even increasing the frequency for a subset of patients. Studies did reveal that levels of norepinephrine and GABA could be increased with this stimulation, and effects on inflammatory cytokines could also be affected, similar to electroacupuncture. The invasive nature of transcutaneous vagal nerve stimulation, with an implanted device under the skin powered by a battery, was a drawback until companies developed a more miniaturized device. In 2007, researchers at Frederick-Alexander University, in Germany, studied the potential of simple vagal stimulation under the ear, near the path of cranial nerve 10, and achieved similar effects, with decreased activity in the amygdala, hippocampus and parahippocampal gyrus, and temporal gyrus, measured with functional MRI (see study link below in additional information). This type of stimulation could be considered almost identical in scope, technique, and psychometric results to many studies with electroacupuncture.

By 2013, we see that a number of prestigious University Medical Schools are seriously endorsing acupuncture stimulation as a logical treatment to be integrated into the overall treatment strategy for seizure disorders. A joint study, cited below, shows that the University of Texas, Yale University, and a major research center in Shanghai, China, are exchanging data that suggests to these researchers that mechanisms now proven in acupuncture are directly applicable to the treatment of seizure disorders, such as the modulation of delta opioid receptors and sodium channels in key areas of the brain, including the hippocampus, and effects on restorative homeostasis of the excitatory and inhibitory controls in the brain, with improved taurine transport and other measurable effects seen in laboratory animals. These are the same goals of current pharmaceutical interventions. Given the poor history of success of standard treatment, and numerous side effects of current drugs, researchers in this field are looking outside the box for more treatment strategies to integrate to increase success. Since there are no proven adverse effects of such treatment, or the common Chinese herbs and nutritional supplements studied in the treatment of seizure disorders, integration of these treatments into a more complete protocol seems sensible. Integrating short periodic courses of acupuncture and electroacupuncture with a modified ketogenic diet, and utilization of proven supplements that may help, such as taurine, magnesium and potassium aspartate, phosphatidylcholine and phosphatidylserine, L-glutamine, P5P and inositol hexacotinate, and various herbs shown to reduce neural excitotoxicity and pro-inflammatory cytokine expression, may allow both the reduction of seizure frequency and decrease in chronic need for drugs with adverse health effects. In the near future, a cannabidiol-rich oil extract may be added to this protocol if desired. The potential for such Integrative Medicine for patients afflicted with epilepsy is great, and the only side effects with this Complementary Medicine is better overall health and disease prevention.

Refining the guideline protocol for acupuncture in the treatment of epileptic disorders and associated health problems is now the focus of research. Studies of electroacupuncture effects have shown that some types of frequency, intensity and choice of points is of course more beneficial, and studies of laboratory animals has indicated that a higher frequency stimulation at more direct points, such as GB20 at the base of the skull, may in fact lower the seizure threshold, but that lower frequencies will improve the keys areas of the brain and beneficially modulate function. A 2015 randomized controlled study at National Taiwan University School of Veterinary Medicine, and the China Medical University, in Taichung, Taiwan, followed up on animal studies that previously showed that a 100 Hz stimulation at these direct points may lower the seizure threshold, and showed that a 10 Hz stimulation of GB20 Feng chi points suppressed seizure activity and decreased sleep disruptions caused by seizure activity (PMID: 26150021). Such study will guide more effective therapy with acupuncture and electroacupuncture in the future. There has been no actual human clinical cases of adverse effects with acupuncture and electroacupuncture in the treatment of patients with seizure disorders to date, but the ability to measure the effects in the brain more accurately will surely produce more and more useful information for practitioners. Of course, the actual clinical treatment in TCM therapy includes an array of synergistic treatments that complement standard treatment, not just one specific acupuncture protocol.

Utilizing dietary regimens to treat disease, especially epilepsy

Research and clinical practice are uncovering a variety of dietary regimens that are proven effective to successfully treat disease, in some cases better than pharmaceutical regimens. Despite these sometimes dramatic findings, there is still a failure in standard medicine to adopt these dietary treatment regimes in standard treatment guidelines, and many patients that could be helped are not benefiting from them.

Perhaps the most well-known figure in the history of Western Medicine is Hippocrates, whose famous set of medical ethics is still recited today in standard medicine. Hippocrates, in his writings, exhorts physicians to utilize dietary medicine to treat patients whenever possible, to "do no harm", before resorting to treatments with side effects and potentially harmful outcomes. Throughout history, we see examples of public health officials trying to promote dietary regimens that could cure, treat, or prevent disease. Today, sadly, we see an attitude that medical authorities should not interfere in the right of the population to adopt disease causing diets, or in the right of companies to promote unhealthy diet for profit, or use chemicals in foods that cause disease in the population. Despite a rich history of nutrient medicine in the last century, we still have virtually no education in this realm in standard medical education, and a long history of a general contempt and belittling of dietary protocols that treat diseases.

After decades of deriding nutritional healing, much of the general public is now under the impression that only "health nuts" actually believe that dietary protocols may substantially treat serious disease. The truth is that research continues to uncover some startling success with dietary protocols in treatment, yet they are not widely recommended. Even when utilized, the design of clinical dietary treatment often is more difficult than it needs to be and discourages many patients and doctors away from use. Even the research papers that promote dietary treatment often suggest that it is hopeless to believe that the general public will adhere to dietary treatment, and that the real aim of the research is to uncover how they work so that a pharmaceutical therapy can achieve the same results. Searching for the single biochemical action that makes a dietary treatment work is often a fruitless endeavor, though, as the dietary changes result in a complex symbiotic array of biochemical changes, not a single chemical feat. There are a number of issues that the patient population needs to be educated to in order to effectively incorporate sound nutritional medicine into a usable protocol. In this article, a few of the dramatic dietary treatment protocols are presented and discussed, so that patients with these health problems can understand the importance of what food chemistry is ingested.

Seizure disorders and the ketogenic or modified ketogenic diet

About one third of epilepsy patients in the United States do not respond at all to anti-seizure medications. Research around the world has discovered that a ketogenic diet is able to reduce seizures dramatically in a high percentage of these patients. This treatment has passed human clinical trials and is now standard therapy, yet still not widely promoted, and suggested only for patients who fail standard drug therapy. One of these human clinical trials at the University College London found that more than 38% of patients that were not responding to any anti-seizure medication reduced seizure frequency more than 50%, and 7% of these patients that were unresponsive to medications reduced their seizure activity by more than 90% with just a dietary treatment protocol. For children with certain types of drug-resistant seizure disorders, over 70% of the patients reduced their seizure activity by more than 90% with the ketogenic diet. This type of therapy is not a new discovery, though. The ketogenic diet was discovered in research in the early twentieth century and highly utilized, only to be erased from the medical literature when pharmaceutical drugs were developed. A wide array of successful nutritional cures and treatments have been developed and proven over centuries, only to disappear from standard medicine when they competed with profitable pharmaceutical treatments in the last century.

The principles of the ketogenic diet may be applied to all patients with beneficial results. The key to this is educating the patient and a pro-active role by patients to treat or even prevent neurological disease. The fact that the ketogenic diet works so well on over 70 percent of the most difficult cases of seizure disorders in children, but has much less success with adults, only points to the more complex physiological imbalances that have developed in the adult patient population. The intelligent patient wants to understand these health problems and treat them, even if they are content with chronic use of the antiseizure medications.

The amount of propaganda ridiculing the medical efficacy of nutritional medicine in standard practice, and in the standard media, is overwhelming. Even in the face of dramatic success, such as the use of a ketogenic diet for difficult cases of epilepsy, medical experts state that the true goal is to find a pharmaceutical drug to replace the diet. These experts parrot the party line that diets are hard to stick with and thus undependable as a standard therapeutic protocol. They do not recommend to all seizure patients to adopt some form of even modified ketogenic diet as a trial to see if a nutritional medical regimen could effectively serve as an adjunct therapy to improve outcomes and reduce medication use. While we might say that at least there is some improvement in the attitude of standard medicine, and we should be happy to see this, it is hard to be happy that the science of nutritional medicine is only terribly maligned instead of horribly maligned. What we need to see is real integration of nutritional medicine and the physicians that study this specialty, namely Naturopathic and TCM physicians.

Even though there is now a growing use of Naturopathic Medicine in the United States, and Traditional Chinese Medicine, or the specialty of Acupuncture, which has always utilized nutritional medicine, has achieved some increase in popularity, the standard public response to real nutritional cures is still abject skepticism. A high percent of the population sees these cures as a social political assault on modern medicine, and not as a valuable medical adjunct to integrate into standard care. While interest in nutritional medicine is now very high in the realm of advertised supplement pills, almost everyone believes that nutritional medicines only help one keep a little healthier, and serve as a substitute for poor dietary habits. The time for the public to realize that nutritional medicine is the most effective and safest area of medicine, and for our basic educational systems to educate our children on basic nutritional science, is now. This is not to say that we shouldn't utilize pharmaceutical science, but to realize that nutritional science has been the basis for public health thoughout civilization, and needs to be maintained as the root of our health care system today. Integrating nutritional medicine into standard care will achieve relief of suffering for many patients, dramatically prevent disease and reduce national health care cost (perhaps helping to save our government financially), and reduce the family insurance costs over time.

Nutritional medicine in the treatment of Neurological disorders

The ketogenic diet utilized to treat epilepsy works by shifting the metabolism of cellular energy production away from glucose, or carbohydrates, to other mechanisms of ATP (adenosine triphosphate) production. Theoretically, this allows the nerve cells to utilize potassium channels to achieve better modulation and control of excessive bursts of nerve firing, which is the physiological basis of seizure acitivity. The firing of nerves in our bodies, and in fact all electrical acitivity, is the result of a complex system utilizing the electrical charges on molecules such as minerals. Neuronal membranes work by passing highly charged cation and anion mineral molecules (ions) across membranes, especially utilizing sodium (Na++) and potassium (K++). Most of our charged potassium molecules reside inside the cell membrane, and most of our charged sodium exists outside the cell. Upon stimulation, the sodium charged particles cross into the cell, and the potassium exits, providing electrical current that creates a nerve signal. The reason that potassium is kept within the cells is that it is highly reactive with even a small amount of water, and is attached to other chemical elements to control its reactivity. Energy to power our cells is provided mainly by a membrane pump, called a sodium potassium ATP-ase pump. This enzyme controlled pump in our cell membranes uses ATP to pump 3 sodium ions out and 2 potassium ions into the cell to create a potential charge, or electrochemical gradient, on the cell membrane. Potassium and sodium must thus be kept in a very tight homeostatic balance in the body. Circulating sodium and potassium is hormonally regulated and the kidney excretes or reabsorbs these charged electrolytes as needed. Unfortunately, the bioavailability of potassium inside cells cannot by easily assessed by our endocrine system, and intercellular potassium may not be optimal. Usable potassium molecules are found mainly in the diet in fresh vegetables and fruits, beans and whole grains. Our modern diet of processed foods and a high percentage of meat has the potential to deplete potassium stores in our bodies. When this occurs, the body's homeostatic mechanisms react by having the endocrine system and kidney work harder to maintain a homeostatic balance.

Potassium channels in our cell membranes are the most abundant type of ion channel in our bodies. Ion channels are specialized proteins or lipoproteins that are found in cell membranes and regulate the passage of large charged mineral molecules such as potassium, sodium, calcium and magnesium. Sodium and potassium channels are the most abundant cell membrane ion channels in our bodies, and these channels, or gates, are opened and closed by chemical or electrical signals, temperature, or a mechanical force. Our central nervous system utilizes these ion channels to transmit nerve signals, and they are key components of the transport of nutrients into cells, activation of immune T-cells, and release of insulin. These ion channels are specialized, and there may be over 300 types of ion channels in a living cell. There are over 40 known type of potassium channels, and they are known mainly for their role in repolarizing cell membranes after a nerve cell is fired. Potassium channels specialized to allow potassium into the cell freely, but not out of the cell, are affected by ATP, and these appear to be very important in restoring a homeostatic control of seizure activity. Potassium channels may be activated by calcium ions, and to a lesser extent by sodium and chloride ions, and gated by the electrical gradient, or balance of ions. While the ketogenic diet is known to work by allowing the brain cells to utilize potassium channels more effectively to control excess firing, the exact mechanisms are complex and continue to elude researchers. Besides the ketogenic diet, a number of other therapeutic protocols will be discovered that allows even greater effectiveness of treatment as research progresses. Of course, this will only occur if public research explores the field of holistic treatment protocols more fully, and works to develop more sophisticated integrated and complementary therapies.

What exactly is the ketogenic diet? This diet involves a low intake of simple carbohydrates and meals with a high fat and protein content, which stimulates the usage of ketone bodies instead of glucose in brains cells for fuel. In medical clinics the diet is introduced and carefully measured, with the patient eating predominantly fatty meats and dairy products. Many clinics will add MCT oil to the diet to decrease the amount of meat and dairy fat, which is an oil high in medium-chain triglycerides. Health concerns with this diet of mainly fatty meat and dairy, or a large amount of an oil that causes GI upset, are of course considerable. After the popularity of the Atkins diet, and numerous reports that when this diet was used, seizure frequency was greatly reduced, John Hopkins Hospital studied a modified Atkins diet and found that it also reduced seizure frequency by more than 50% in 43% of patients and by more than 90% in 27% of patients. Given the success of a diet that was less unwholesome, some physicians then studied a simple low glycemic index diet, which also produced similar results to the harsh classic ketogenic diet, with about half of the patients experiencing a greater than 50% reduction in seizure frequency, and with overall figures about equal to the harsh classic ketogenic diet. Finally, in 2009, after nearly 100 years of knowledge and use of the ketogenic diet, it is "discovered" that a healthy low glycemic index diet that can be very palatable, incorporating many vegetarian fats, oils, and complex carbohydrates, is just as effective as a clinical diet that was limited to eggs, bacon, cheeseburgers, whipping cream, and canned tuna. All patients with seizures can benefit, and half of them very significantly, with a healthy diet that actually consists of wholesome food. This means that the patient would avoid refined sugars, pastries and breads, and eat meals that have plenty of healthy oils and fats. A certain amount of complex carbohydrates, such as whole grains, and even some honey, maple syrup or agave, as sweetener, is acceptable in the diet, but avoidance of refined and processed foods is important. Even foods such as french fries often have a high simple sugar content, and should be avoided.

While the traditional Atkins Diet promoted a low-carb diet that was high in meat fats, studies in recent years have demonstrated that a modified Atkins Diet, sometimes cynically called an Eco-Atkins diet, incorporating vegetable-derived fats and proteins, had a dramatically decreased risk of cardiovascular disease over a diet heavy in meat fats. Dr. Frank Hu, a professor at the Harvard School of Public Health, published such as study in the September 7, 2010 issue of Annals of Internal Medicine (cited below). Many studies have shown a high risk of cardiovascular disease, cancer etc. from low-carb, or low-glycemic index diets, that are heavily meat based, and the effects of a ketogenic diet may be obtained from a primarily vegetable and whole grain diet. Why medical clinics that offer the seizure patient a ketogenic diet as a treatment option continue to recommend a diet that is almost entirely meat and dairy based is the key question. Is standard medicine serious about dietary treatment, and can we trust their advice?

When choosing to adopt a healthy controlled diet to reduce seizures, many patients may ask why, if the drugs work well. The most effective antiseizure medications are phenytoin (Dilantin), phenobarbital, carbamazepine, and primidone. Chronic use of these medications, though, result in sometimes intolerable side effects, particularly with phenobarbital and primidone. All of the medications almost eliminate seizures in 27% of patients, and significantly reduce seizures after 3 years use in 75% of patients who did not stop taking the drugs due to intolerable side effects, which ranged from 3-25% of patients. Common side effects of Dilantin, which is tolerated the best, with chronic use, include sedation, impaired memory, slurred speech, decreased coordination, confusion, dizziness and headaches. Enlarged tissue in the gums and mouth, or gingival hyperplasia, change facial appearance in 20-40% of patients, and increased hair growth (hirsutism), acne and coarseness of facial features with long-term use is also very common. Often chronic use of antibiotics is prescribed to control acne, which itself presents problems of candidiasis, more frequent urinary tract infections, and gastrointestinal dysfunction. A smaller percentage of patients experience peripheral neuropathies and dyskinesias (tremors, sustained muscle contractions distorting posture, voice problems) and other involuntary muscle disorders, which often affect motor abilities in the hands. Skin rash is also seen in 5-7% of patients, and often steroids or antihistamines are chronically prescribed as needed, themselves causing side effects. These rather alarming common side effects with chronic use are usually downplayed to the patient when the treatment is started. With use of a dietary treatment, dosage of these harsh drugs, and the side effects with chronic use, may be reduced, and potentially, the seizure disorder in a percentage of patients could be reduced enough over time to try to withdraw the medication. Of course, this would depend upon the cooperation of the prescribing physician, which brings us back to the adoption of standard treatment guidelines that include nutritional medicine. Presently, very few neurologists would agree to utilizing a ketogenic diet with a healthy low-glycemic index as an actual therapy.

Ketone bodies are just three water soluble compounds that are by-products of fatty acid metabolism, produced when these fatty acids are broken down to be used as energy for cells. The three ketone bodies are acetone, acetoacetic acid, and beta-hydroxybutyric acid. The key ketone body that seems to be important in the control of seizure activity is beta-hydroxybutyric acid, which is actually a carboxylic acid, which is an organic acid (carbon-based) that contains at least one carboxyl (-CO2 H). The most common carboxylic acid is vinegar, or acetic acid, which is the most acid, or pH, neutralizer known. Other well known carboxylic acids are citric acid (Vitamin C) and tartaric acid (in tamarinds). Carboxylic acids are weak acids, meaning that they only partially breakdown and produce positively charged hydrogen ions, the measure of acidity. Some other examples of carboxylic acids include valeric acid in the herb valerian, caproic acid in goat fat, caprilic acid in unrefined coconut milk, lauric acid in unrefined coconut oil, palmitic acid in unrefined palm oil, and arachidic acid in peanut oil. Fatty acids are carboxylic acids that are very important to our health. Some unsaturated fatty acids are now well known as nutrient medicines, and are key components many medicinal herbs. The omega 3 and 6 essential fatty acids, EPA and DHA, are now well utilized in nutrient supplementation, and linolenic and linoleic acid supplements are also becoming popular. These fatty acids are utilized by the liver and other cells in the body to manufacture prostaglandins, which regulate inflammatory processes. Inclusion of these healthy essential fatty acids in a ketogenic diet is an intelligent choice. A diet rich in essential fatty acids would include healthy amounts of unrefined olive oil, coconut oil, wheat germ oil, safflower oil, walnut oil, sesame oil, and various other healthy nut and seed oils, as well as oily fish, butter, and possibly some high oil content meats, such as pork. Avocadoes are high in oil content with high healthy essential fatty acids, as are fresh nuts and seeds. A low-glycemic index diet that includes a high percentage of healthy essential fatty acids is not hard to design, and many cookbooks may now help with creating some delicious recipes. Even some desserts may be incorporated into this dietary protocol, especially when the herb Stevia is used instead of sugar, and rich desserts with either dairy fat or vegetables oils can be designed to fit into a low glycemic index high fat ketogenic diet. Many vegetarian foods are very high in protein content as well, especially when beans, whole grains and soy products are used. We see from the pathophysiology of seizure disorders and excitotoxicity the need for key amino acids, such as glutamine and glycine, and a natural whey protein supplement may be added to the modified ketogenic diet to provide both generation of ketones and supply of needed proteins, derived not from unhealthy meat and saturated fats, but from healthy organic chemical-free plant-based foods.

A ketogenic diet utilizes periods where a high fat intake stimulates the body to utilize stored fats as a source for fuel instead of stored carbohydrates. This was the basis for the popular Atkin's diet. When people wanted to burn more stored fat, they ate a predominantly fatty meal, and then (hopefully) exercised, burning the stored fat. This, of course, did not work so well in sedentary persons, and created health problems for people that ate poor quality, or unhealthy, fats. Dr. Atkins insisted that poor quality meat fats worked just as well as healthy plant fats, but he died of cardiovascular disease at an early age. His fats-are-fats sociopolitical putdown of so-called health nuts did not serve him well. Sensible people utilized this diet by taking in healthy fats, such as the fats from olives, avocados, walnuts, whole grains, etc. as well as organic dairy products, and following up this type of meal with some exercise. Subsequently, the popular Mediterranean Diet, utilizing healthy fats, became very popular in weight loss regimens. The ketogenic diet decreases the ATP metabolism of carbohydrate mechanisms (glycolysis) and increases the utilization of stored fats (triglycerides) to stop inhibition of potassium channels, or to better utilize stored cellular potassium. This type of diet, as well as high potassium diets, were heavily researched by the mid-twentieth century by Max Gerson, a German MD who researched nutritional healing to cure or inhibit cancer. Of course, standard pharmaceutical medicine portrayed poor Dr. Gerson as a quack.

Production of ketone bodies, or ketogenesis, occurs when fatty acid oxidation produces enough acetyl Coenzyme A to create a conversion of this essential cellular fuel to ketone bodies. Ketone bodies are normal everyday fuels utilized throughout the body. A ketogenic diet may produce protection against neuroexcitability and seizures when there is a deficiency of essential fatty acids, or excess need for fatty acids due to oxidative stress, or a genetic or epigenetic trait that alters fatty acid metabolism. Correcting fatty acid imbalances may significantly benefit many seizure patients. Besides glucose, ketone bodies are our brains only other effective fuel. A lack of carbohydrates pushes the brain cells to utilize more ketone bodies for fuel, and this in turn places an emphasis on potassium channels, preventing excess calcium ions from entering the cells and stimulating hyperexcitation and cell destruction. As we research this subject more extensively, we may uncover a number of novel nutritional protocols to help seizure disorders, such as achieving a better balance of essential minerals, chelating toxic minerals from the body, and achieving better hormonal balance to help the body regulate calcium and other essential minerals that are highly regulated. So far, there has not been enough research in this realm to provide a comprehensive strategy, but the public could demand that such research in nutritional medicine is stepped up. This would be funded not by pharmaceutical research, but by public research.

What do the researchers at Harvard have to say about the ketogenic diet and its remarkable success? Their HMS neurobiology project states that the ketogenic diet is remarkably effective, but alas, poorly understood. The basic findings in research by Harvard researchers Weiyuan Ma, Jim Berg, and Gary Yellen find that the ketogenic diet applies to all types and ages of seizure patients, and appears to enhance a natural homeostatic antiseizure protective mechanism, rather than target specific causes of epilepsy. During periods of high fat utilization in the metabolism, certain ketone bodies (acetoacetate and beta-hydroxybutyrate) are increased in circulation and provide an alternative fuel source for cellular energy, including the brain. Seizure protection is then increased, but this protection is lost quickly when the patient ingests a sizable supply of sugar. The creation of the seizure protection takes time, as the body creates a balance of enzymes and protein transporters, but the breakdown of the effect in studies is quick when refined sugar is ingested. These Harvard researchers state that seizure protection appears to be lost within ten minutes when the patient eats a candy bar, for example. With adequate bioavailability of these specific ketone bodies, the neural cells were able to utilize slower firing channels to control the hyperexcitability of neurons, which is the basis for seizure activity. When reading the Harvard research, one sees that the aim of this research appears to be to discover a new pharmaceutical that achieves ketogenesis, rather than to discover practical ways to introduce a variety of dietary protocols that could benefit the seizure patients.

What are these ketone bodies acetoacetate and beta-hydroxybutyrate, and why do they prevent seizures? Acetoacetate is a simple molecule that easily turns into beta-hydroxybutyrate with the addition of a hydrogen ion. Hydrogen ions are the simple charged molecules that create energetic potential in the body, and determine what we call acidity, or pH. Acetoacetate and beta-hydroxybutyrate, in combination with other metabolites, also release insulin from cells. Insulin controls much of the nutrient transport into the brain, and plays an important role in the degree of effect that drugs and other molecules have on brain cells. Research has found that insulin resistance syndrome increases the risk of Alzheimer's and other neurodegenerative diseases. As the pieces of the puzzle accumulate, we find that increases in specific ketone bodies may also prevent seizures by helping the brain utilize the regulatory effects of insulin. So there may be more than one physiological benefit from a ketogenic diet in the control of neuroexcitability and seizures.

Mitochondrial health has become a very important subject in the treatment and prevention of neurological disorders and neeurodegeneration. Mitochondria are parts of our cells that manufacture most of the cellular energy. Mitochondria play two important roles in insulin secretion, one role is ATP production, which stimulates insulin release via activation of potassium channels in the cell membrane, and opens calcium channels in the membrane, allowing calcium into the cell, which in turn, allows insulin to be released. Insulin is a hormone that plays an extensive role in regulation in the body, and in the brain plays unique roles in neuroregulation.

In addition, researchers may be overlooking the effects of other chemicals besides sugar in foods that break down the neuroprotective effects of a ketogenic diet. Candy bars and other sugary foods contain a variety of chemicals that act as excitotoxins in the brain, and much research has linked these excitotoxins to seizure activity, and the pathology of migraines, neuroendocrine disorders, and various neurodegenerative disorders. What are excitotoxins? Common additives in processed foods, such as hydrolyzed vegetable protein, aspartame, MSG (monosodium glutamate), and artificial flavorings have been found to have a dose-dependent toxicity in the brain. In 1969, Dr. John Olney, a neuroscientist at Washington University in St. Louis, found that in animal studies, excess MSG caused discrete lesions in the hypothalamus, the main neuroendorine regulatory center in the brain, and subsequent studies showed widespread CNS damage attributed to excess MSG in the brain. Glutamate is a key neurotransmitter in the brain, and introduction of excess monosodium glutamate may accelerate the effects of glutamate, which opens calcium channels on cell membranes, allowing excess calcium ions to damage the cell or trigger neural hyperexcitability. This effect is identical to the effects that are controlled by the ketogenic diet. In addition, the Harvard research shows that the ketogenic diet works dramatically on more than 90% of children with drug-resistant seizure disorders that have been diagnosed with brain lesions.

A large study of children diagnosed with Attention Deficit and Hyperactivity Disorder, another neurodegenerative disease associated with brain cell hyperexcitability, showed an amazing improvement in symptoms for patients who were given foods that contained no benzoic preservatives or artifical food additives or high fructose corn syrup. The UCLA study indicates that these excitotoxins play a potentially large role in the ADHD disease mechanism. Public health studies have also demonstrated how diets with whole grains and fresh vegetables and fruits improved neurodegenerative conditions with the elderly dramatically, and how incorporation of key whole grains, such as barley, improved memory significantly. These findings are still not incorporated into public health and standard medical guidelines, though. If such dietary science were applied to standard medicine, the health benefits may be enormous.

What can we learn from studies of the ketogenic diet

While the complex biomechanisms associated with seizure disorders may sem overwhelming, there is a set of basic assumptions that we can make from the success of the ketogenic diet. 1) A diet that includes refined carbohydrates, chemical additives, processed foods, and lacks healthy vegetable fats should be avoided by all patients with a seizure disorder; 2) Essential fatty acids should be utilized in the treatment protocol to provide antioxidant effects, help regulate inflammation, and to correct metabolic disorders; 3) Metabolic disorders, such as insulin resistance, and problems with chronic acidity, lack of potassium in the diet, and mineral deficiencies should be address in comprehensive therapy. These dietary considerations may not only provide significant improvement in seizure reduction, but also benefit one's health in many ways.

How do these nutritional imbalances explain seizure disorders? A seizure is an uncontrolled paroxysmal excessive dishcharge of the central nervous system, and a common denominator in scientific study is increased permeability of neuronal cell membranes leading to neuro-hyperexcitation. The most well known causes of seizures are deficiencies in calcium, glucose and oxygen, and problems with cell membrane stability. These causes may come from degnerative disorders, metabolic disorders, toxin accumulation, vascular disease, infectious disease, congenital abnormalities, tumors, or other types of brain lesions when the seizure is due to a secondary cause. Primary seizure disorders are still poorly understood, and may be due to a variety of these underlying problems.

Specific herbal therapies may also play a key role in maximizing the effects of a modified ketogenic diet to control seizures. Research has uncovered a variety of herbs that may affect cellular potassium channels. For example, chemicals in ginseng have been found to work by increasing intracellular calcium ions and affecting cell membrane function via cellular enzymes such as phosphatidylinositol 3-kinase (PI3), and the effects of ginseng are inhbited by chemicals that inhibit potassium channels. This implies that ginseng helps cells maintain potassium channel activation. A number of nutrient medicines may also benefit this effect, such as phosphatidylcholine, a lipid metabolite of lecithin, and inositol hexacotinate, a type of Vitamin B3, or niacin. Deficient phosphatidylcholine levels in brain cell membranes have been linked to memory loss, neurodegeneration and aging. The Chinese herb Uncaria rhyncophylla, which is used to treat neurological disorders, contains a chemical rynchophylline, that research shows affects voltage-gated potassium channels, and modifies nerve responses by accelerating slow-activated potassium channel responses. The active mechanisms of Uncaria chemicals are related to opening of potassium channels, blocking of calcium channels, and regulation of neurotransmitter transport and metabolism. Such research in the last few years demonstrates the advances being made to find research oriented holistic protocols, and take advantage of new findings in research to devise more effective treatment strategies.

A combination of a ketogenic low-glycemic index diet, or a modified primarily vegetarian Atkins diet, with herbs such as ginseng and uncaria, and nutrient medicines such as phosphatidylcholine and inositol hexacotinate, may provide a relatively simple and healthy regimen that could drastically reduce seizure activity. Of course, there are a number of Chinese herbs proven to aid in prevention and reduction of seizure activity, as well as those that address key underlying health imbalances that contribute to the seizure disorders, and a professional herbalist that is knowledgable and keeps up with current research, such as a Licensed Acupuncturist, may provide an individually tailored herbal and nutrient regimen synergistic with dietary therapy. For example, animal research in China in 2009 found that extracts from the Chinese herb Astragalus significantly reduced seizure activity that was induced in the laboratory. The chemical effects were attributed to the herb's ability to clear oxidant and lipid free radicals, and clear aldehyde damage to mitochondria in brain cells. Aldehydes are chemicals that may accumulate in cells and tissues with alcohol intoxication and candidiasis, and there may be a genetic or epigenetic trait in individuals that decreases the ability to clear aldehydes. This may be one reason why alcohol ingestion increases seizure activity in many cases. This study demonstrates one of many examples of efficacy in the incorporation of Chinese herbs into an integrated treatment protocol.

A 2009 survey at the University of California in San Francisco found that 56% of patients with epilepsy that were surveyed reported use of dietary and herbal therapy, and 71% of these patients reported this to their neurologist. Most of these patients utilized dietary and herbal therapy for general health promotion, though, and not for treatment of seizure disorder. Their medical doctors, who generally received no formal training in either nutritional or herbal medicine, often warned of potential dangers or drug-herb interaction, or the potential of herbs to increase seizure activity, and discouraged herbal and dietary medicine. This common practice exists despite a lack of clinical cases of injury to a patient from herb-drug interactions, and implies that any herbal medicinal protocol is potentially risky. Such advice is not supported by either clinical evidence or recent research. This study (cited below) confirms the adherence of a general concept in standard medicine to resist incorporating proven nutritional and herbal medicines into an integrated treatment protocol. When the Complementary Medicine physician, in the form of a Licensed Acupuncturist and herbalist, provides proven researched nutrient and herbal medicines of professional quality, individually prescribed in the correct dosage, combined with short courses of acupuncture and electroacupuncture, and even physiotherapy when needed, the patient is assured of the greatest efficacy from this nutrient and herbal therapy.

By 2013, we see that a number of prestigious University Medical Schools are seriously endorsing acupuncture stimulation as a logical treatment to be integrated into the overall treatment strategy for seizure disorders. A joint study, cited below, shows that the University of Texas, Yale University, and a major research center in Shanghai, China, are exchanging data that suggests to these researchers that mechanisms now proven in acupuncture are directly applicable to the treatment of seizure disorders, such as the modulation of delta opioid receptors (2-10 Hz) and sodium channels in key areas of the brain, including the hippocampus, and effects on restorative homeostasis of the excitatory and inhibitory controls in the brain. These are the same goals of current pharmaceutical interventions. Given the poor history of success of standard treatment, and numerous side effects of current drugs, researchers in this field are looking outside the box for more treatment strategies to integrate to increase success. Since there are no proven adverse effects of such treatment, or the common Chinese herbs and nutritional supplements studied in the treatment of seizure disorders, integration of these treatments into a more complete protocol seems sensible.

Research into the effects of Cannabidiol and Cannabidivarin on the brain and its potential as an anti-epileptic anti-seizure medication

Clinical evidence of the benefits of 'marijuana', or Cannabis, for patients with seizure disorders has prompted serious research into these effects. While the most studied chemical, THC (tetrahydrocannabinol), has the potential to overstimulate the brain, other chemicals in Cannabis, or marijuana, have once again shown great potential for medical use. These chemicals, Cannabidiol (CBD) and Cannabidivarin, have shown great potential in laboratory studies for the treatment of seizures, some cancers, and neurodegeneration, which are proceeding to larger human trials. CBD does not produce euphoria or intoxication and its primary activity is just the modulation of endogenous cannabinoid recepetors, stimulating the CB2 receptors much more than the CB1. A long and controversial history of sociopolitical, economic, and medical issues is the main stumbling block in finding ways to best utilize these chemicals in treatment.

Scientific study of Cannabis was banned by the U.S. government, and the U.S. Treasury Department issued a tax in the early part of the twentieth century based on unsubstantiated claims that marijuana use resulted in insanity, and caused criminal behavior. The tax was opposed by the young American Medical Association (AMA) because many Medical Doctors prescribed marijuana. This marijuana tax was issued, but was not a ban on marijuana as a harmful drug, because prior studies failed to show harm, such as the Indian Hemp Drugs Commission report of 1893, by colonial authorities in British India. At one time hemp was a major crop in the United States, and the low cost of production competed heavily with the timber and cotton industries, adding to the attitude against marijuana. In response to this tax, a large study was conducted by the New York Academy of Medicine in 1939, called the La Guardia Committee report, which surprisingly found no serious adverse effects, but a number of measurable health benefits to marijuana. This commission study was attacked and received no serious consideration, heavily opposed by Harry J. Anslinger, a friend of timber interests such as the powerful William Randolph Hearst, and the President of the United States. Before this, marijuana had a long history as a medicinal herb, but after the widespread introduction of opiates after the Civil War, there was a fear that marijuana would affect the sales of opiates. In 1925, the United States government supported regulation of Indian Hemp, or Cannabis, as a medicinal drug within the framework of the International Opium Convention. A highly sensationalized anti-marijuana campaign failed to find evidence supporting Cannabis as a narcotic, though, and so a tax was invented to discourage cultivation and transportation. Anslinger was able to get the American Medical Association (AMA) to issue findings of a study of the LaGuardia Committee, which claimed that most of the clinical study group was black, nullifying the findings, and that marijuana led to criminal behavior and narcotic abuse, and so Harry Anslinger, Commissioner of the U.S. Treasury Department Federal Bureau of Narcotics, was able to enforce a stopping of all scientific studies on marijuana after 1940. Only in 1972 did the American Medical Association and other institutions admit that the reports of the dangers of cannabis were largely false and included racially motivated warnings, prompting decriminalization of marijuana in many state and local communities. While there were many long-standing local laws prohibiting marijuana in the United States, no federal sentencing for possession of marijuana was enacted until 1956, and this was rarely enforced until the 1960s. By the 1970s, many states nullified these prison sentences, and in 2012, marijuana was legalized in a number of states, prompting a renewal of interest in its history as a medicine. After a long history of confusing debate concerning the benefits versus the adverse effects of marijuana, fed by even more confusing sociopolitical issues, racism, and questions of libertarian freedoms, marijuana is finally back in the arena of medicine.

Historically, strains of Cannabis have been used medicinally around the world. In China, a strain of Cannabis was the first recorded anesthetic used in surgery, and attempts by modern researchers have indeed uncovered some strains of marijuana that contain cannabinoids that are very potent in pain relief, both internally and topically, although the particular Cannabis strain useful as an anesthetic still eludes investigation. Endogenously produced cannabinoids are now well studied, and studies have confirmed a range of beneficial effects in the body, from neuroprotection to wound healing. The effort to find some evidence of actual scientific proof of harm continues vociferously, though, perhaps part of a more generalized negative attitude that has now persisted for over a century, or due to longstanding economic and sociopolitical pressures. The obvious temporary euphoria and impairment seen with marijuana is generally mild, but the association of marijuana effects with negative social behaviors has a strong connotation for many individuals, precluding its use. This leaves the question of use as a medicinal herb complicated. The obvious benefits in relief of glaucoma, chronic pain, loss of appetite and fatigue with cancer therapy, insomnia, and mood disorders has convinced even conservative patients of the benefits, though.

In 2013, the reporting of the positive and remarkable benefits in treating a 5 year old girl in Colorado with frequent intractable seizures, often hundreds per day, and resistant to any form of treatment, rendering her helpless and almost unresponsive, appeared on a television special by Dr. Sanjay Gupta. The effects of a marijuana extract with low THC content produced an instantaneous and dramatic improvement in this girl's seizure disorder, reducing seizures from over 100 per day to about 1 per week. Also in 2013, the reporting of dramatic benefit for a 7 year old girl, MyKayla Comstock, dying of leukemia and unresponsive to standard treatment, in Portland, Oregon, was widely reported, with not only pain relief, return of appetite and vigor, but surprisingly, a remission of her lymphocytic leukemia. This anticancer effect is also being investigated, with positive findings of an array of physiological benefits in cancer therapy, and physiological explanation of a potential anticancer effect. A study at the Virginia Commonwealth University Medical College, in 2006, provided proof of mechanisms by which delta9-tetrahydrocannabinol induced cell death in specific leukemia cell lines, as well as exerting beneficial anti-inflammatory and antioxidant effects (PMID: 16908594). Both of these children quickly became habituated to the euphoric effects of chemicals in their medications and resumed a normal, active and healthy routine. The array of strong reaction to this treatment, ranging from condemnation and threat to an outpouring of support, reflects the long and complex sociopolitical background to the issue of marijuana. The denial of research into medical uses of Cannabis for the last 70 years may have caused needless suffering for untold patients, but now modern research may finally help direct therapy in useful and specific ways.

By 2015, studies at the Sichuan University School of Medicine, in Chengdu, China, showed that cannabidiol (CBD) inhibited seizure activity in laboratory animals with chronic epilepsy, and positively affected brain tissue and function as well. CBD was shown to decrease excessive growth of astrocytes and neuronal damage in key areas of the brain, such as the hippocampus, which were attributed to the chronic epileptic syndrome, and excitotoxicity of the NMDA glutamate receptors was also seen (PMID: 26309534). This is just one of many sound studies conducted around the world that show an array of valuable effects and applications. While standard pharmaceuticals may suppress biological activity to help control seizures, Complementary and Integrative Medicine provides protocols that can also improve the underlying pathophysiology and perhaps lead to better long-term outcomes, and a healthy approach to treatment would be to integrate dietary, nutritional, herbal and acupuncture therapies for a thorough and integrated approach that achieves the healthiest outcomes. The U.S. National Institutes of Health (NIH) now supplies a conservative review of CBD that shows that a number of small human clinical trials have been very successful and show and array of benefits and no adverse health effects. To see this information, just click here: https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/biology-potential-therapeutic-effects-cannabidiol. It is revealing that this information has to be supplied by the National Institute on Drug Abuse instead of the Institute devoted to neurological disease. The continuing neurosis concerning "pot" that denies the use of valuable herbal medicines found in the plant that are proven safe and effective, that do not produce "drugged effects" and are not addictive, is astounding. The fact that cannabis and chemicals in cannabis have a legitimate medical use should have taken it off of the Schedule One list, and only sociopolitical neurosis obviously prevents this.

How soon we will see the completion of larger human clinical trials of specific chemicals in marijuana that inhibit seizure activity is still to be determined due to fierce opposition to the use of this inexpensive weed medicinally, but the research findings in the last decade do provide hope for seizure patients. The renewed interest in the complex endogenous cannabinoid system in the nervous system is also opening up novel biologic pharmaceutical possibilities for treatment of epilepsy. Research in 2012 at the University of North Carolina found that the endocannabinoids anandamide and 2-arachidonoyl glycerol have been implicated in protective signaling against exitotoxic episodes, including seizures, and research indicated that drugs that block enzymes that break down these endocannabinoids promote neuroprotection that may be useful to offset a number of diseases associated with excitotoxicity in the brain (see study link below). As more research is funded worldwide, the hope for an array of therapeutic tools is high. Currently, the family that has developed and grown cannabis rich in cannabidiol and low in THC, and donated it free of charge to parents to treat their children dying of severe epileptic syndromes, is now developing a cannabidiol-rich oil that has very little THC and will not be used for recreational purposes, and is marketing this supplement as a nutritional medicine. It remains to be seen whether the federal government will prosecute this family for their efforts as they provide this medicinal oil to help many patients across the country with epilepsy, and the Complementary Medicine physicians that will direct this holistic treatment protocol. Since no one can get high from cannabidiol-rich cannabis oil extract, the public can assume that if this family is prosecuted, that it will only be because the federal government is under the control of pharmaceutical lobbying. Hopefully, our elected officials will do what is right and allow such proven medicines to be more available in Complementary Medicine.

Information Resources and Additional Information with Links to Scientific Studies

  1. The physiological mechanisms of epilepsy have been poorly understood due to the many factors involved, and types of seizure disorders. Inflammatory dysfunction is now thought to be integral to both the onset and perpetuation of the disease, and interleukin-1 beta (IL-1b) overexpression contributes to neurodegeneration, poor regulation of normal cell death cycles (apoptosis), dysfunction of receptor-gated ion channels, gene expression, and excitotoxicity: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1867084/
  2. A 2008 overview of research into the role of inflammatory dysfunction and the complement system in innate immunity in both the onset of epileptic disorders and the perpetuation of the disesase was published in the journal of the American Epilepsy Society. This review of scientific literature shows that specific protein complements and cytokines are overexpressed in most types of epileptic disorders, but especially in temporal lobe epilepsy, associated with the hippocampus and limbic system, which is particularly resistant to current drug therapies: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2384155/
  3. A 2014 study at China Medical University, in Taichung, Taiwan, showed that electroacupuncture was able to reduce key inflammatory markers related to epileptic seizures and overexcitation of areas of the brain related to seizures. Both auricular acupuncture with 2Hz stimulation and body channel acupuncture with 2 Hz stimulation at the points ST36 and ST37 reversed neuron overexcitation occurring in laboratory animals that was tied to chronic inflammation in the hippocampus, while sham acupuncture had not effect. Such study elucidates clearly that mechanisms by which integration of acupuncture and electroacupuncture into the overall treatment for epilepsy could greatly benefit patients. Of course, inclusion in this holistic TCM therapy of specific herbal and nutrient medicines could provide even more Complementary benefit, and short course of TCM therapy would be very inexpensive, and healthy overall: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4131505/
  4. A 2010 New York Times article reveals research that finds that a ketogenic diet is dramatically effective for reducing seizure episodes in epilepsy, and could be applied to other neurological diseases. Of course, a modified ketogenic diet could also help as part of a larger treatment protocol, and should be explored: http://www.nytimes.com/2010/11/21/magazine/21Epilepsy-t.html?src=me&ref=general
  5. The HMS Neurobiology website at Harvard Medical School gives basic info on how the ketogenic diet works to control epilepsy: http://yellen.hms.harvard.edu/keto.php
  6. One of the Harvard researchers of the ketogenic dietary treatement for epilepsy maintains this informative website: http://neuro.med.harvard.edu/faculty/yellen.html
  7. A 2009 study at the University of California in San Francisco demonstrates that while a high percentage of patients try to utilize dietary and herbal medicine into a treatment protocol, that standard MDs continue to discourage this use and warn of negative effects, rather than incorporating research-based integrative protocols into the treatment plan: http://www.ncbi.nlm.nih.gov/pubmed/19486356
  8. A 2012 overview of the effects of auricular acupuncture on the autonomic nervous system reveals the promise in this type of needle stimulation in the overall treatment protocol for epilepsy, aiding parasympathetic tone. Autonomic imbalance, as measured by the increased sympathetic activity and reduced parasympathetic is one of the hallmarks of epilepsy, and acupuncture is able to provide an array of benefits related to seizure disorders in the same treatment session: http://www.ncbi.nlm.nih.gov/pubmed/22461842
  9. A 2011 study at the China Academy of Chinese Medical Sciences, in Beijing, demonstrates how specific types of electrical stimulations in auricular acupuncture decreased the frequency of epileptic seizures in laboratory experiments, and helps guide future treatment: http://www.ncbi.nlm.nih.gov/pubmed/22379786
  10. A 2013 joint report by the The University of Texas Medical School at Houson, Yale University School of Medicine, and the Shanghai Research Center for Acupuncture and Meridians, found that while seizure disorders are still poorly understood, that neuroexcitability in key areas of the brain related to seizures could be successfully treated by several mechanisms now proven to occur with acupuncture stimulation, such as attenuating neuronal excitability via regulation between delta opioid receptors and sodium channels and enhancing the homeostatic inhibitory system in the brain: http://www.ncbi.nlm.nih.gov/pubmed/23662118
  11. A 2015 study at the National Taiwan University School of Medicine, Mackay Medical College, and Aletheia University, Taipei, Taiwan, showed in a randomized controlled study that low frequency (10-25Hz) electroacupuncture at the Feng-Chi points (GB20) on the scalp is beneficial in improving epilepsy and epilepsy-induced sleep disruptions, mediated by opioid receptors in the amydala central nucleus (CeA). Prior studies had shown that high frequency acupuncture at these points showed no apparent benefits, and one study has found that such high frequency stimulation at this point, GB20, could actually modulate the seizure threshold, and so these Universities did this study to show that a 10Hz stimulation is both safe and effective. Such studies are helping to create better guidelines for the practice of acupuncture: http://www.ncbi.nlm.nih.gov/pubmed/24165229
  12. A 2014 study at China Medical University, in Taichung, Taiwan, showed that a 2Hz electroacupuncture stimulation at the points ST36 and ST37, combined with appropriate points affecting the hippocampus and brain stem on the ear, for just 3 treatments per week for 6 weeks, ameliorated a key aspect of repeated epileptic seizures, the growth of mossy fibers in the hippocampus in laboratory animals with induced epilepsy. Such research shows that specific protocols may be combined to greatly enhance the treatment of epilepsy with an integrated medical approach: http://www.ncbi.nlm.nih.gov/pubmed/25045697
  13. A 2012 study at the Pusan National University School of Korean Medicine found that acupuncture at a single point, HT8, on laboratory animals, inhibited cell death in the hippocampus and suppressed kainic acid induced inflammatory events in a modulatory manner, suggesting that this treatment could play a significant role in the overall treatment with acupuncture and herbal medicine: http://www.ncbi.nlm.nih.gov/pubmed/22773088
  14. A 2013 study at Capital Medical University School of Public Health, in Beijing, China, showed that there is a similarity between the effects of anterior nucleus thalamus high-frequency deep brain electrical stimulation, now touted in standard medicine for the treatment of epilepsy, and specific electroacupuncture treatments that affect this area of the brain. It was demonstrated that both treatment techniques affected levels of glutamate, aspartate, GABA and taurine at these neuronal transmitters: http://www.ncbi.nlm.nih.gov/pubmed/23810460
  15. A 2013 study at Shanghai University of TCM in China further refined the guidelines for electroacupuncture in treatment for epilepsy, showing that 100 Hz generally has a greater effect in laboratory animals with induced epilepsy than 10 Hz, but that the 10 Hz stimulation worked best at the combination of points ST40 and K1, and 100 Hz worked best at the combination of points DU26 and DU14. 100 Hz stimulation was less effective than 10 Hz at the point combination DU8 plus EXB9. One study in China has found that 100 Hz stimulation at GB20 may lower the seizure threshold for some patients, and that in general a 10-25 Hz stimulation at points around the cervical spine may be more efficacious, while a combination of 2/100 Hz alternating in distal points produced better effects in key areas of the brain to modulate activity of various opioid receptor types. Such study continues to refine the very safe and effective, and relatively inexpensive, protocol in acupuncture, and provides us with the most efficacious treatment guidelines, combining short courses of acupuncture and electroacupuncture with specific herbal and nutrient medicines, and dietary advice to achieve the most proven comprehensive treatment protocol for integration into standard pharmaceutical therapy: http://www.ncbi.nlm.nih.gov/pubmed/23589718
  16. A 2013 study at the National Taiwan University School of Veterinary Medicine, and the China Medical University, in Taichung, Taiwan, found that 100 Hz stimulation to the GB20 points in animals did not decrease induced seizure activity with pilocarpine, or seizure related sleep disorder. A 2015 follow-up study showed that a 10 Hz stimulation at these direct points, GB20 Feng chi at the base of the skull, did lower the seizure threshold in these study animals with induced seizures, and decreased the sleep disturbances. Such study is revealing more exact guidelines for acupuncturists in the treatment of human seizure disorders: http://www.ncbi.nlm.nih.gov/pubmed/26150021
  17. A 2015 study at Central South University, in Changsha, China, found that the Chinese herbal chemical Huperzine A, long proven as a potent acetylcholinesterase inhibitor without the adverse effects of pharmaceutical cholinesterase inhibitors, is useful in the treatment of epilepsy, relieving oxidative glutamate toxicity in key areas of the braine, such as the hippocampus. Huperzine A is available with synergistic herbal chemicals in the formula Vinpurazine by Health Concerns: http://www.ncbi.nlm.nih.gov/pubmed/26440805
  18. A 2011 study at China Medical University in Taichung, Taiwan, demonstrates how the most common Chinese herb used in formulas to treat seizures, Uncaria rhyncophylla (Gou teng) reduces epileptic seizures in laboratory studies by decreasing hippocampal hyperexcitobility as well as aiding the health of glial support cells in laboratory animals with seizures induced by excess kainic acid: http://www.ncbi.nlm.nih.gov/pubmed/21402140
  19. A follow up 2014 study at China Medical University in Taichung, Taiwan, clarified the pathways of benefit for the Chinese herb Uncaria rhyncophylla (Gou teng) in the treatment of epileptic seizures, noting in studies of laboratory animals with an induced seizure disorder that the key herbal chemical rhyncophylline upregulated beneficial inflammatory modulating cytokines, such as IL-18, as well as brain-derived neurotrophin factor (BDNF), which are involved in the toll-like receptors and other pathways associated with the disease. The chemicals in the herbal extract were also found to downregulate key inflammatory cytokines associated with seizure disorders, such as IL-1beta. Gou teng is traditionally used in a formula called Tian ma Gou teng Yin, but increased dosage, perhaps standardized, could perhaps exert a more significant treatment effect: http://www.ncbi.nlm.nih.gov/pubmed/24636743
  20. A 2014 study at Pusan National University, in Yangsan, South Korea, found that the Chinese herb Gastrodia elata (Tian ma) exerts its proven and significant neuroprotective effects mainly through the upregulation of expression of the P13K signaling pathway in association with brain-derived neurotrophin factor (BDNF), and that an alcohol extract of Gastrodia elata, especially when combined with N-acetyl cysteine, prevented adverse effects of glutamate toxicity and oxidative damage, key factors in the pathophysiology of epilepsy and other neurological disorders. We see from such studies the positive benefits of such classic Chinese herbal formulas as Tian ma Gou teng Yin, as well as the potential to enhance these effects of inflammatory modulation and neuroprotective effects with addition of higher dose alcohol extracts of Tian ma and Gou teng, or standardized extracts: http://www.ncbi.nlm.nih.gov/pubmed/25004888
  21. A 2013 study at Pusan National University, in Yangsan, South Korea, also showed that the common Chinese herb Polygonum multiflorum (He shou wu) exerted significant neuroprotective effects against glutamate toxicity in the hippocampus, and alleviated both inflammatory and oxidative stress, indicating its vaue in a more comprehensive formula to prevent or treat epilepsy and other neurological diseases: http://www.ncbi.nlm.nih.gov/pubmed/23973786
  22. A 2011 study at China Medical University in Taichung, Taiwan, demonstrates how herb Apocynum venetum (Jiao gu lan) inhibits voltage-gated sodium and potassium channels to exert significant inhibition of neuroexcitability, the main focus of most anti-epileptic drugs: http://www.ncbi.nlm.nih.gov/pubmed/21530630
  23. A 2013 study at Shanghai University, China, found that an active chemical in the Chinese herb Acorus gramineus (Shi chang pu), commonly used to ameliorate seizure disorders and calm anxiety, works by enhancing GABA inhibition at the hippocampus, and presumably other regulatory centers in the brain, a key aspect in the mechanism of seizures. This study also showed the modulatory effects of the herbal chemical, alpha-asarone, which enhanced tonic GABA inhibition, but left phasic GABA inhibition unaffected, showing specific effects to stop tonic seizure muscle effects, or tonus: http://www.ncbi.nlm.nih.gov/pubmed/22975146
  24. An overview of the proven effects of acupuncture stimulation on neurotransmitters, cytokines and neural growth factors, or neurotrophins, by the Institute of Neurobiology and Molecular Medicine, in Rome, Italy, shows the broad promise of integration of acupuncture into the treatment protocol for epilepsy: http://www.ncbi.nlm.nih.gov/pubmed/20451467
  25. Further research by the Institute of Neurobiology and Molecular Medicine, in Rome, Italy, in 2011, demonstrates the potential of acupuncture, electroacupuncture, and even deep tissue physiotherapy, or tui na, to improve nerve growth factor availability and utilization, and at the same time counter the major side effects of new pharmaceutical drugs being utilized to treat chronic neurological disorders such as epilepsy. Much research has demonstrated the potential of specific nutrient and herbal chemicals to enhance nerve growth, with products now available combining these chemicals in formula: http://www.ncbi.nlm.nih.gov/pubmed/21701996
  26. A 2009 study at the Shanghai Institute of Acu-Moxibustion and Meridians, specifically proves the anti-epileptic effects of electroacupuncture on laboratory subjects, and shows how downregulation of excess calcium ion excitation in the hippocampus explains this effect: http://www.ncbi.nlm.nih.gov/pubmed/19761108
  27. A 2007 study at Friedrich-Alexander University, Elangen-Nuremberg, Germany, found that single treatments of trancutaneous vagal nerve stimulation (tVNS) without the need for an implanted device under the skin, could achieve the same effects, with effects on norepinephrine and GABA reducing excess activity in the amydala, hippocampus and surrounding gyri, as measured by functional MRI and other means. This is very similar to measured effects with specific electroacupuncture. We might say that modern medicine is merging with TCM: http://www.ncbi.nlm.nih.gov/pubmed/17564758
  28. A 2005 study at Shanghai Medical College of Fudan University, in China, found that both depletion of taurine and poor taurine transport in the brain rendered laboratory animals more susceptible to induced seizure activity, and that specific electroacupuncture treatments increased taurine transport in the cortex, hippocampus, striatum and cerebellum. The treatment used intermittent stimulation at 64 Hz, close to the natural frequency of firing in the brain for all neurons, at the points DU26 and K1. Of course, some of the most effective points for stimulation and modulation of brain activity are located at these more sensitive areas of the body, and patients need to understand that at times these more uncomfortable points may be the most effective in treatment. Such study as this proves the specific benefits of such therapy to improve patient confidence in acupuncture: http://www.ncbi.nlm.nih.gov/pubmed/16617689
  29. A 2013 meta-review of taurine metabolism and its effect on seizure threshold, at Tampere University Hospital in Finland, showed that taurine (2-aminoethenesulfonate) is a ubiquitous free amino acid (found in all cells) that serves to hyperpolarize brain neurons to control excess firing. Since the early 1980s, studies have found that a depletion of taurine, or deficient taurine transport, was involved in a large subset of epilepsy patients, although taurine deficiency is not required to decrease seizure threshold. Such studies reveal that the supplement taurine may be an inexpensive and healthy addition to a holistic treatment protocol: http://www.ncbi.nlm.nih.gov/pubmed/23410665
  30. An overview of neuroecxitotoxins and their effects is found on this website: http://www.rense.com/politics6/excito.htm
  31. The Harvard School of Public Health provides an overview of guidelines on fats in the diet, revealing how we determined that healthy natural vegetable fats are important to our health, while a simple low-fat diet has no significant benefits: http://www.hsph.harvard.edu/nutritionsource/nutrition-news/low-fat/
  32. A 2010 article in Bloomberg Businessweek reveals current research findings by the Harvard School of Public Health that a modified Atkins Diet, with most of the fats and proteins derived from vegetable sources, dramatically reduces cardiovascular risk: http://www.businessweek.com/lifestyle/content/healthday/642824.html
  33. A website maintained by the University of Sydney, Australia, gives key facts explaining glycemic index and helping you to determine what carbohydate foods are healthy in a low glycemic load diet: http://www.glycemicindex.com/
  34. A 2011 interview with Dr. Colin Campbell, author of The China Study, the premier scientific text on the health benefits of a plant-based diet, and the health risks that were generated by a meat based modern diet: http:/well.blogs.nytimes.com/2011/01/07/nutrition-advice-from-the-china-study/?ref=health/
  35. A 1995 study found that key lignans and bioflavonoids exerted significant inhibition of the enzymes that drive hormonally driven cancers, such as prostate and breast cancers, by inhibiting 5alpha-reductase and 17beta-hydroxysteroid hydrogenase. These include enterolactone, biochanin A, genistein, and equol: http://joe.endocrinology-journals.org/cgi/content/abstract/147/2/295
  36. A 2007 study by the Scripps Research Institute in La Jolla, California, found that interferon-gamma induced enzymatic activity is implicated in the pathogenesis of various neurological disorders. Specifically, an enzyme the controls the rate of breakdown of the amino acid tryptophan (catabolism of) is induced by interferon-gamma, leading to neurotoxicity by generating quinolinic acid, an NMDA agonist. A number of herbal and nutrient chemicals have been found to suppress the production of neurotoxic quinolinic acid, including curcumin (E zhu, Yu jin, turmeric), epigallocatechin gallate (green tea), and catechin hydrate (milk thistle). : http://www.ncbi.nlm.nih.gov/pubmed/17661345
  37. A 2010 study of the effects of simple electroacupuncture stimulation on modulation of key areas of the temporal lobe, and connectivity between these regulatory centers, especially the amygdala, cingulate cortex, hypothalamus, and insula, demonstrates the proven capacity of acupuncture to normalize brain function. This study, at the Chinese Academy of Sciences, in Beijing, China, utilized functional MRI studies to demonstrate these modulatory effects, which have been duplicated now in many such studies: http://www.ncbi.nlm.nih.gov/pubmed/21044291
  38. A 2010 study of the mechanisms of acupuncture on modulation of brain function was conducted at Harvard Medical School and Massachusetts General Hospital with fMRI studies, concluding that different techniques of needle stimulation produced differing modulatory effects on correlated areas of the brain, especially the amygdala and hypothalamus, and that acupuncture appears to mobilize these brain centers to functionally achieve improved correlation, to mediate dysfunction. This study is just one of series of studies being conducted at Harvard that supports professional acupuncture needle stimulation to achieve significant benefits in restoring brain homeostasis. This study also notes that the psychophysical response of the patient plays a part in this treatment effect, which supports the utilization of acupuncture in a traditional TCM setting, with time-intensive interaction between patient and practitioner. Use of the acupuncture in standard medicine often relies upon too-short of sessions, too little rapport between patient and physician, and medical doctors with little training in the subtle needle manipulations. In TCM practice in the United States, too much emphasis has also been made concerning avoidance of stimulatory responses in treatment, decreasing the effectiveness of acupuncture to avoid momentary unpleasant reaction to needle stimulation. These studies support acupuncture practice as it is performed in China, by professionals that are highly trained in technique, and patients who understand the value of the needle stimulation and responses: http://www.ncbi.nlm.nih.gov/pubmed/20494627
  39. A 2012 meta-review of scientific studies of acupuncture stimuli and its effects on the brain, by Charite University Medical Center, in Berlin, Germany, also confirms that fMRI studies, also utilizing other objective measurements, clearly proved that acupuncture had broad affects on brain function, not just sensory areas associated with pain perception. These studies proved that acupuncture stimulation affected regulatory centers (affective) as well as cognitive processing, and showed that the effects were modulating, or restorative of homeostatic balance, rather than just increasing or decreasing brain functions. These studies, 34 meeting the highest standards in review, clearly showed that acupuncture stimulation affected the limbic system, brain stem, and basal ganglia, which are integral to the dysfunctions seen in syndromes involving insomnia: http://www.ncbi.nlm.nih.gov/pubmed/22496739
  40. A 2010 study of the effects of electroacupuncture at just two points, P5 and P6, on the wrist, showed that this stimulation inhibits sympathetic nervous system excitability, a hallmark of waking insomnia. This study, at the Susan Samueli Center for Integrative Medicine, at the University of California at Irvine, California, near Los Angeles, showed how this acupuncture stimulation activated serotonin-containing neurons in the nucleus raphe pallidus and brainstem to inhibit autonomic reactions of increased heart rate and blood pressure during periods of excitability, which are highly correlated with waking episodes during deep sleep REM. The research also showed how the standard research model to gauge neuroexcitability in these brain centers, injection of kainic acid overdose to induce neural excitability (commonly use to simulate anxiety and epileptic episodes in the laboratory), reversed this electroacupuncture effect, proving that the electroacupuncture stimulation indeed acted to inhibit specific neuronal chemical effects: http://www.ncbi.nlm.nih.gov/pubmed/20133441
  41. A 2013 study of Cannabidiol and Cannabidivarin, chemicals in Cannabis, or marijuana, at the University of Reading School of Pharmacy, United Kingdom, found that indeed these chemicals exerted very significant anticonvulsant effects in laboratory animals, and the Cannabidivarin was not mediated by cannabinoid receptors. This study confirms positive studies, mainly at research facilities in Israel, that have confirmed the anti-seizure effects of Cannabis for over a decade: http://www.ncbi.nlm.nih.gov/pubmed/23902406
  42. A 2012 meta-review or all published studies on marijuana and the efficacy for the treatment of epilepsy was conducted by the esteemed Cochrane Database Systematic Review, and although it is acknowledged that marijuana is proven to have significant anti-epileptic effects in animal studies, only 4 small randomized human clinical studies were accepted in standard medical journals so far, with insufficient data to come to a reliable conclusion on efficacy, although no adverse effects were noted. The prohibition on the scientific study for decades, since the positive findings in the LaGuardia study of the 1940s, has led to a lack of scientific information published: http://www.ncbi.nlm.nih.gov/pubmed/22696383
  43. A 2013 study of the effects of Cannabidiol, a chemical in Cannabis, or marijuana, that is studied for treatment of a variety of health problems, including epilepsy, cancer, and neurodegenerative disorders, by the University Complutense, in Madrid, Spain, found that, contrary to speculation by other neurologists, that this chemical has an inhibitory effect on the inactivation of of endocannibinoids (cannibinoids produced in the brain), acts also through the serotonin and adenosine systems, activating metabotropic (cell membrane signaling) receptors, the PPAR family (inflammatory regulation), and exerting significant anti-oxidant and anti-inflammatory effects: http://www.ncbi.nlm.nih.gov/pubmed/22625422
  44. A 2012 study at the University of North Carolina, Pembroke, North Carolina, U.S.A. identified 2 specific endogenous cannabinoids that protect against excitotoxicities, such as seizure disorders, and developed a chemical that blocks enzymes that break down these endogenous cannabinoids, thus offering increased protection against these diseases: http://www.ncbi.nlm.nih.gov/pubmed/22270809
  45. A 2015 study at Sichuan University School of Medicine, in Chengdu, China showed that cannabidiol given to laboratory animals with induced chronic epilepsy both decreased seizure activity and improved pathological effects such as excess astrocyte growth and neuronal damage in key areas such as the hippocampus, and reduced excitotoxicity in the glutamate NMDA receptors: http://www.ncbi.nlm.nih.gov/pubmed/26309534
  46. A 2016 review of Cannabis and the endocannabinoid system, by experts at All-India Institute of Medical Sciences (AIMS), Department of Pharmacology, in Rajasthan, India, shows that medical Cannabis products are now legal and standard in practice in a number of countries, including the United Kingdom, New Zealand, and Spain, and that endocannabinoids are proven to play modulating and protective roles in many diseases, including epilepsy, multiple sclerosis, schizophrenia, cancers, chronic inflammatory disease, gastrointestinal diseases, pain disorders, Metabolic Syndrome, and cardiovascular disease: http://www.ncbi.nlm.nih.gov/pubmed/27086601http://www.ncbi.nlm.nih.gov/pubmed/27086601