Complementary and Alternative Medicine (CAM) use in Children with Epilepsy

Abstract

Complementary and alternative medicine (CAM) use by the pediatric population with epilepsy in rural Pennsylvania was studied to characterize the prevalence, perceived effectiveness, and reasons for CAM use. This study additionally assessed the adequacy of parent-physician communication regarding CAM usage. A telephone survey was administered to 200 parents/caregivers of children with epilepsy followed at Hershey Medical Center. Thirteen percent of respondents indicated CAM use by their child. Common types of CAM used were cannabis-related products such as CBD oil and medical marijuana. Forty-eight percent of CAM users chose to initiate CAM owing to dissatisfaction with the outcomes of antiseizure drugs. Fifty-nine percent noticed a decrease in seizure frequency with CAM use, and more than 11% of CAM users reported side effects from CAM. Eighty percent of CAM users had discussions regarding CAM with their child's neurologist. CAM use was found to be associated with increased seizure severity ( P = .004) and the prior use of cannabidiol (Epidiolex) ( P < .001) or the ketogenic diet ( P = .001). Increased seizure severity and the prior use of Epidiolex or the ketogenic diet may be used as predictors for the identification of patients with a higher likelihood of using CAM. Interest in future CAM use, especially cannabis-related products, was expressed in a large percentage of non-CAM users. Given the high parental or caregiver interest in CAM, providers are encouraged to be proactive in initiating discussions about CAM and collaborate with parents/caregivers to ensure the safe usage of CAM among pediatric patients.

A Review of the Multi-Systemic Complications of a Ketogenic Diet in Children and Infants with Epilepsy

“…Examples include neuromodulators such as vagal nerve stimulators (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS) [ 3 ]. Patients looking for non-surgical options turn to complementary medicinal options such as herbal remedies, supplements, or cannabis-related products [ 4 ]. Finally, a frequent option for the control of refractory epilepsy is the ketogenic diet (KD) [ 5 ].…”

Use of non-medical cannabis in epilepsy: A scoping review

“…No additional works of interest were detected. With 55 records being excluded from the full-text screening phase, 66 records were included in the final analysis ( 2 , 4 , 10 , 11 , 21 – 82 ). The data selection flowchart is presented in Figure 1 .…”

“…The following section is summarized in Table 1 . Of the 66 included studies, 45 (68%) included only or mostly (i.e., >50%) adult participants ( 10 , 11 , 22 , 24 – 28 , 30 , 32 , 33 , 36 – 39 , 41 – 43 , 46 , 48 – 50 , 52 – 63 , 66 – 68 , 71 , 72 , 75 , 76 , 78 – 80 , 83 ), whereas 21 (32%) included only or mostly (i.e., >50%) pediatric participants ( 21 , 23 , 29 , 31 , 34 , 35 , 40 , 44 , 45 , 47 , 51 , 64 , 65 , 69 , 70 , 73 , 74 , 77 , 81 , 82 , 84 ). Most studies (88%), both adult and pediatric, were published after 2010 ( 10 , 11 , 21 – 29 , 31 , 32 , 34 , 35 , 38 – 58 , 60 – 66 , 69 – 84 ).…”

Neurology — to be or not to be of the cannabis-based medicine?

“…This edition of the Polish Journal of Neurology and Neurosurgery contains a Leading Topic dedicated to the use of cannabis-based medicine (CBM) in neurology. Growing evidence supports the application of CBM in a variety of neurological disorders such as epilepsy [1][2][3][4][5], multiple sclerosis (MS) [6][7][8][9], chronic pain [10], agitation in Alzheimer's Disease [11], Parkinson's Disease (PD) [12][13][14], Huntington's Disease [15,16], Gilles de la Tourette Syndrome (GTS) [17], and other movement disorders [15]. Although there are disparities regarding the level of evidence for the use of CBM in diverse neurological disorders, with the highest being in epilepsy and MS, in all cases it is still considered an adjuvant and/or experimental therapy.…”