Like all nerve tissue, our brains rely on electrical impulses to receive and send messages. Electrical currents that enter our brains through the spinal cord or optic nerves allow us to process billions of pieces of information and react to our environment, scratching an itch here, swerving to avoid a confused groundhog there or adding a comma here.......or is it there? Normally, electrical currents move through the brain in an orderly and limited fashion. In epilepsy, however, the currents get short-circuited or out of sync for a variety of reasons. The result is a burst of electrical activity that causes a seizure, which can be anything from a staring spell, called an absence seizure, to a full-fledged grand mal, complete with jerking arms and legs and loss of consciousness.
People can become seizure-prone for many different reasons. “An injury to the brain from an accident, a stroke or lack of oxygen during birth, alcohol abuse, poisoning, a severe bacterial or viral infection such as meningitis or encephalitis and high fever may all cause seizures,” says James Neubrander, M.D., a doctor in private practice in Hopewell, New Jersey, with a special interest in epilepsy and nutrition.
Nutrients Can Play a Role
Less commonly, seizures are the result of a metabolic disease, an inherited disorder that results in an inability to properly utilize a particular nutrient in the body, such as a vitamin or an amino acid. “Seizures associated with metabolic disorders usually begin soon after birth and rarely start after age six,” says Robert J. Gumnit, M.D., president of the Minnesota Comprehensive Epilepsy Program and director of the Epilepsy Clinical Research Center at the University of Minnesota, both in Minneapolis.
In about half of these cases, the metabolic disorder can be figured out. “A specialist, a pediatric neurologist, may consider 20 to 80 different metabolic disorders that are most commonly associated with seizures,” Dr. Gumnit says. Sometimes seizures can be controlled by a diet that restricts certain foods. Children with a condition called phenylketonuria, for instance, need to avoid the amino acid phenylalanine, found in large amounts in aspartame (a sugar substitute).
Adding more of a nutrient may help others. Children who develop seizures because their bodies have a hard time using vitamin B6, for instance, may take 25 to 50 milligrams of B6 each day, an amount large enough to overcome metabolic roadblocks.
If you think your child has seizures because of a metabolic disorder, see a specialist for a diagnosis, Dr. Gumnit urges. Don’t try to treat a metabolic disorder on your own.
Seizures can also be caused by nutritional deficiency. “Most doctors, however, think that nutritional deficiency is only rarely the cause of repeated seizures,” Dr. Gumnit says. Shortages of magnesium, thiamin, vitamin B6 and zinc have been reported to be associated with seizures in some individuals. These nutrients, among numerous others, are needed for normal chemical reactions in the brain.
Nutritional support for people with seizure disorders, then, involves correcting metabolic problems and nutritional deficiencies. In some cases, it may also involve taking larger amounts of certain nutrients to help protect against drug-related damage and, in theory at least, against damage caused by the seizures themselves.
“There’s absolutely no reason that optimum nutritional support can’t be combined with traditional treatment,” Dr. Neubrander says.
Here’s what seems to be helpful.
Vitamin E Helps Prevent Seizures
There is good reason to believe that vitamin E could be helpful for some kinds of seizures. Animals given vitamin E are more resistant to seizures induced by pressurized oxygen, iron and certain chemicals. And clinical studies show that people taking antiseizure drugs have reduced blood levels of vitamin E.
That’s why researchers at the University of Toronto decided to test vitamin E in 24 children with epilepsy whose seizures could not be controlled by medication.
They found that the frequency of seizures was reduced by more than 60 percent in 10 of 12 children taking vitamin E supplements. (They took 400 international units a day for three months in addition to their regular medication.) Six of them had a 90 to 100 percent reduction in seizures. By comparison, none of the 12 children who took placebos (inactive substances) along with their medication improved significantly.
What’s more, when the children who were taking placebos were switched to vitamin E, seizure frequency was reduced 70 to 100 percent in all of them. The researchers noted that there were no adverse side effects.
“Vitamin E apparently has no direct anti-epileptic action,” says Paul A. Hwang, M.D., the study’s main researcher, associate professor of neurology in the University of Toronto Department of Pediatrics and Medicine and director of the epilepsy program at the Hospital for Sick Children in Toronto. In other words, once a seizure is taking place, vitamin E can’t help. “But it may act as a scavenger of free radicals in some forms of epilepsy, such as post-traumatic seizures, and so help protect the membranes of brain cells.”
Free radicals are unstable molecules that are generated by chemical reactions involving oxygen. These molecules are potentially harmful because they grab electrons from the healthy molecules embedded in cell membranes, damaging the protective membranes. Free radical scavengers called antioxidants, such as vitamin E, offer free radicals their own electrons and so save cell membranes from harm, Dr. Hwang explains.
In animals, seizures can be induced by chemicals that produce free radicals (ferrous chloride, for instance). Iron from blood that gets into the brain after a head injury may cause seizures in the same way, Dr. Hwang says. “And the seizure itself generates more free radicals, possibly setting up a cycle that leads to frequent seizures,” he adds.
Dr. Hwang and his colleagues continue to use vitamin E with good results in their patients with seizures who don’t respond to standard anticonvulsant drugs. “It’s not a cure-all, but it can be very helpful,” he says. “If someone is going to be helped by vitamin E, the benefits will be apparent in about three months.”
He has found that 400 international units daily of d-alpha-tocopherol acetate, the most biologically active form of vitamin E, is safe and effective even in children as young as age three. (Nutrition experts say that infants under age one should not be given more than 50 international units daily.) Most adults can safely take up to 600 international units without problems, but don’t take more than this amount daily without medical supervision. These high amounts are not easily available from foods, says Dr. Hwang.
“It’s important to work with a doctor on this,” Dr. Hwang adds. “In some cases, under medical supervision, it may be possible to reduce the dosages of some seizure drugs.”
| Food Factors Most cases of epilepsy are not treated with dietary changes, but some are. Here are a few things that might prove helpful. Ask your doctor about a ketogenic diet. A diet virtually devoid of starches and sugars and high in fat has been used as a treatment for children whose epilepsy cannot be controlled with drugs or who have to take such high doses of drugs that side effects become intolerable. "The diet makes the body burn fat, not sugar, for energy and produces waste products called ketones that are thought to help suppress seizures," explains John M. Freeman, M.D., professor of pediatric neurology at Johns Hopkins Medical Institutions in Baltimore. Studies suggest that about 30 percent of children who try the diet have their seizures completely controlled; another 40 percent have enough benefit to warrant staying on the diet. Some are able to reduce medication, some have fewer seizures, and some function better. Most children who benefit stay on this very restrictive diet for two years, then gradually begin to eat more starches and sugars. Often the children eventually stop the diet and find their seizures do not recur. Vitamin and mineral supplements are necessary during this diet, since it is low in fat-soluble vitamins and calcium. Critics say the diet is too high in fat and is unhealthy for growing children. But, says Dr. Freeman, "we've seen no evidence of heart disease or growth problems." Avoid aspartame. The official word, from the Food and Drug Administration's Center for Food Safety and Applied Nutrition, is this: Aspartame is not likely to cause seizures. (An important exception: It will cause seizures in people with phenylketonuria, a metabolic disorder that makes it difficult to break down phenylalanine, an amino acid found in aspartame.) Nevertheless, there are scattered reports of seizures associated with this food additive in apparently healthy people. A report from Ralph G. Walton, M.D., former chief of psychiatry at Jamestown General Hospital in New York, describes a woman who switched from sugar to aspartame to sweeten her iced tea. Since she drank about a gallon of tea a day, she was exposed to large amounts of aspartame. After a few weeks of the artificially sweetened drink, she began having seizures. Doctors could find nothing wrong. The seizures stopped when she switched back to sugared tea. Use common sense, experts suggest. "If you're getting more than a serving or two of aspartame a day, try eliminating it completely from your diet for at least one week and see if it helps," suggests James Neubrander, M.D., a doctor in private practice in Hopewell, New Jersey, with a special interest in epilepsy and nutrition. Go easy on alcohol. People who drink too much have three times the normal risk of developing epilepsy, a risk similar to that of people who've had head injuries or central nervous system infections. In adults newly diagnosed with epilepsy, alcohol abuse accounts for symptoms in one in four, report researchers from Columbia University in New York City. Ease up on coffee. "Although most can tolerate two to three cups of coffee or tea a day without trouble, a small percentage of people with epilepsy are very sensitive to caffeine and shouldn't take it at all," says Robert J. Gumnit, M.D., president of the Minnesota Comprehensive Epilepsy Program and director of the Epilepsy Clinical Research Center at the University of Minnesota, both in Minneapolis. Check for food triggers. Food sensitivities may cause seizures, especially in people with personal or family histories of food allergies or sensitivities, says Dr. Neubrander. Such people might have additional symptoms such as migraines, recurrent stomach pains, diarrhea and hyperactivity. "Everyone is different, however, and may react to any food to which the body is sensitive," Dr. Neubrander points out. Pinpointing trouble foods can be difficult, so find a specialist in food allergy testing. It's possible to be sensitive to a food and not know it. It's also very common for a person to eat the very food he is sensitive to on a daily basis, says Dr. Neubrander. In a study by researchers at the Hospital for Sick Children in London, doctors found that cow's milk, cheeses, citrus fruits, wheat and two food additives, tartrazine and benzoic acid, are mostly likely to cause seizures in children with epilepsy. According to Dr. Neubrander, tartrazine (a food dye known as FD&C Yellow #5) and benzoic acid (a preservative) are found in thousands of foods, and the best way to avoid them is to read food labels. "Though certain foods are more commonly implicated as offenders, it is important to note that everyone is biologically different and therefore reacts differently to any food or food additive," adds Dr. Neubrander. |
| Prescriptions for Healing There are a number of nutrients that have proven useful in helping to prevent seizures. But please note: These supplements are meant to provide optimum nutritional support, not to be treatments in and of themselves. It's important to work with a doctor knowledgeable in nutrition, especially if you are giving nutritional supplements to children. These are the nutrients that doctors recommend. Nutrient Daily Amount
Folic acid No more than 2,500 micrograms for children ages 5-15 , 400-5,000 micrograms for adults 1,600 micrograms for women of childbearing age on antiseizure drugs 3,000 micrograms for women on antiseizure drugs who are planning to become pregnant, taken for 3 months before stopping birth control (requires a prescription) Selenium 50-150 micrograms for children , 50-200 micrograms for adults Nutrient Daily Amount
Vitamin E 400 international units for children ages 3 and over (d-alpha-tocopherol acetate) 400-600 international units for adults (d-alpha-tocopherol acetate) Plus a multivitamin/mineral supplement containing the Daily Values of all essential vitamins and minerals
MEDICAL ALERT: If you have been diagnosed with epilepsy, you should be under a doctor's care. Make sure you are under a doctor's supervision when taking more than 400 micrograms of folic acid daily. High amounts can mask the symptoms of vitamin B12 deficiency, also known as pernicious anemia. Don't take more than 100 micrograms of selenium daily without medical supervision. Don't take more than 600 international units of vitamin E daily without medical supervision. Infants under one year of age should not be given more than 50 international units daily. If you are taking anticoagulant drugs, you should not take vitamin E supplements. |
Selenium May Stop Seizures
The mineral selenium, another nutrient with antioxidant properties, also appears to help control seizures in some children, says Georg Weber, M.D., Ph.D., assistant professor in the Department of Pathology at Harvard Medical School and a researcher at the Dana-Farber Cancer Institute in Boston.
Dr. Weber has found that some children with severe, uncontrollable seizures and repeated infections have low blood levels of glutathione peroxidase, a selenium-dependent antioxidant enzyme.
“We’ve found that giving these children 50 to 150 micrograms of selenium a day significantly reduces their seizures,” Dr. Weber says. “We believe that these children have a metabolic problem that prevents them from using selenium properly and that the problem may be far more frequent than has been believed.”
Talk to your doctor if you’re thinking about taking selenium supplements yourself and especially if you’re considering giving them to your child with epilepsy, Dr. Weber says. Although he has found amounts up to 150 micrograms a day to be safe for children with severe deficiency, children’s needs can vary greatly depending on the amount of deficiency they have, and giving too much selenium could be detrimental to their health.
For adults with epilepsy, experts who use nutritional therapy recommend 50 to 200 micrograms of selenium daily to control seizures. But be sure not to take more than 100 micrograms daily without medical supervision. You can get more selenium from foods if you eat lots of garlic, onions, whole grains, mushrooms, broccoli, cabbage and fish.
Fill Up on Folic Acid
Deficiency of folate (the naturally occurring form of folic acid) isn’t thought to often play a role in the development of seizures. But some antiseizure drugs deplete this B-complex vitamin, sometimes leading to abnormalities in red blood cell formation.
“Folate deficiency can also lead to serious birth defects called neural tube defects,” explains Dr. Gumnit. “These birth defects happen very early in the pregnancy, often before a woman knows she is pregnant.” (For more information on birth defects, see page 113.)
That is why any woman of childbearing age who’s taking antiseizure drugs should also take 1,600 micrograms of folic acid a day, Dr. Gumnit says. And any woman who’s taking antiseizure drugs and planning to become pregnant should also take three milligrams (3,000 micrograms) of folic acid every day for three months before she stops using birth control, he says. (That high amount requires a prescription supplement.)
Other people taking antiseizure drugs should simply take 400 micrograms, the amount of folic acid found in ordinary Make sure that you are under a doctor’s supervision when taking more than 400 micrograms, because high amounts of folic acid can mask the symptoms of vitamin B12 deficiency, also known as pernicious anemia. Some experts say that children ages 5 to 15 may safely take up to 2,500 micrograms of folic acid daily, but it’s best to talk to a doctor about this, Dr. Gumnit says.
Many doctors also recommend a multivitamin/mineral supplement for their patients with epilepsy, and that’s probably not a bad idea. Some research suggests that deficiencies of vitamin B6, zinc and magnesium may also play roles in seizure disorders.
