Medicinal plants utilized in the management of epilepsy in Ethiopia: ethnobotany, pharmacology and phytochemistry

Abstract

Epilepsy is a common central nervous system (CNS) disorder that affects 50 million people worldwide. Patients with status epilepticus (SE) suffer from devastating comorbidities and a high incidence of mortalities. Antiepileptic drugs (AEDs) are the mainstream treatment options for the symptomatic relief of epilepsy. The incidence of refractory epilepsy and the dose-dependent neurotoxicity of AEDs such as fatigue, cognitive impairment, dizziness, attention-deficit behavior, and other side effects are the major bottlenecks in epilepsy treatment. In low- and middle-income countries (LMICs), epilepsy patients failed to adhere to the AEDs regimens and consider other options such as complementary and alternative medicines (CAMs) to relieve pain due to status epilepticus (SE). Plant-based CAMs are widely employed for the treatment of epilepsy across the globe including Ethiopia. The current review documented around 96 plant species (PS) that are often used for the treatment of epilepsy in Ethiopia. It also described the in vivo anticonvulsant activities and toxicity profiles of the antiepileptic medicinal plants (MPs). Moreover, the phytochemical constituents of MPs with profound anticonvulsant effects were also assessed. The result reiterated that a lot has to be done to show the association between herbal-based epilepsy treatment and in vivo pharmacological activities of MPs regarding their mechanism of action (MOA), toxicity profiles, and bioactive constituents so that they can advance into the clinics and serve as a treatment option for epilepsy.

Unfavorable public attitude toward people with epilepsy in Ethiopia: A systematic review and meta‐analysis study

“…69,70 They may also be taken for dangerous cultural and traditional practices 71 like burning their head or the whole body, lightening matches in their nose, watering them during seizures, and giving harmful or potentially poisonous traditional herbal medicines. 72 The idea that epilepsy is a manifestation of supernatural forces makes it difficult to bring epilepsy sufferers to modern medical treatment. 73 Instead, patients suffering from "Moygnbagegn",-a term given to a poorly defined group of conditions including fever, falls, and syncope, too-may be "treated" by bloodletting.…”

“…This is shared by the patients themselves, leading to a double stigma (self and public) 69,70 . They may also be taken for dangerous cultural and traditional practices 71 like burning their head or the whole body, lightening matches in their nose, watering them during seizures, and giving harmful or potentially poisonous traditional herbal medicines 72 …”

Antiseizure Effects of Scoparone, Borneol and Their Impact on the Anticonvulsant Potency of Four Classic Antiseizure Medications in the Mouse MES Model—An Isobolographic Transformation

“…This condition is the fourth most common neurological disorder and affects approx. 1% of the world’s population, 80% of whom live in low- and middle-income countries [ 1 ]. To treat this disease, patients with epilepsy use antiseizure medications (ASMs) and may benefit from other therapies such as brain surgery or neuromodulation [ 2 ].…”

“…Herbs used in traditional medicine remain the first-line treatment for most people with little or no access to ASMs [ 1 , 4 ]. The study of antiseizure effects of these plants using innovative in vivo assays and the identification of their bioactive principles are key aspects of providing pharmacological evidence for their use.…”

Phytochemical constituents, antioxidant and antibacterial activities of Plectocephalus varians (A. Rich.) C. Jeffrey ex Cufod root extracts

“…Plants have been used as a source of medicine in traditional healthcare systems worldwide since immemorial [ 1 ]. Approximately 80% of the primary healthcare demands of low- and middle-income countries to treat different diseases primarily rely on traditional medicines [ 2 ].…”