Epileptic encephalopathies are a group of medical conditions characterized by epilepsy which is difficult to treat and usually progressive in nature. This group comprises of eight age related syndromes which include Early Myoclonic Encephalopathy, Ohtahara Syndrome, West Syndrome, Dravet Syndrome, myoclonic status in non-progressive encephalopathies, Lennox-Gastaut Syndrome, Landau-Kleffner Syndrome, and epilepsy with continuous spike waves. Usually refractory to standard anti-epileptic drugs, these conditions cause a progressive cerebral dysfunction and related physical, mental, and cognitive disabilities. These conditions are usually seen in early childhood and are believed to be due to brain damage resulting from excessive bursts of electrical impulses, during the maturation stage of the brain. Severe cognitive, behavioural and neurological defects can be seen with these conditions, which may even cause early death. Affected individuals who survive to their teens display a reduction in the symptoms of epilepsy; however, residual neurological and cognitive defects are significant.
Most of the syndromes included in epileptic encephalopathies need to be treated aggressively with a combination of new anti- epileptic drugs. These may partially control the convulsions: however, the overall prognosis in most affected individuals remains extremely poor. In such a scenario, Ayurvedic herbal medicines can be judiciously utilized as supportive therapy in order to treat the refractory convulsions, improve and/or prevent cognitive, behavioural and neurological deficits and related symptoms, and improve long-term survival. Though being traditionally refractory to standard treatment, supportive and additional herbal medicines, given in combination and in high doses for prolonged periods – often several years – can bring about significant improvement and maintain the beneficial effect.
Herbal medicines which are useful in these conditions need to perform the role of reducing excessive electrical discharge in the brain cells, and preventing brain damage, as well as preserving and improving the brain’s structural and functional ability to the maximum extent possible. Herbal medicines useful in the treatment of these conditions include Ashwagandha, (Withania somnifera), Brahmi (Bacopa monnieri), Shankapushpi (Convolvulus pluricaulis), Vacha (Acorus calamus), Jatamansi (Nardostachys jatamansi), Sarpagandha (Rauwolfia serpentina), Khurasani Ajwayan (Hyoscyamus niger), Pippalimool (Piper longum), Bala (Sida cordifolia), Yashtimadhuk (Glycerrhiza glabra), and Haridra (Curcuma longa).
Other herbal and herbomineral combination medicines useful in the treatment of these disorders include Bruhat Vat Chintamani Ras, Maha Vat Vidhvans Ras, Vat Gajankush Ras, Brahmi Vati, Sarpagandha Ghan Vati, Dashmoolarishta, Ashwagandharishta, Shankhpushpi Syrup,Saraswatarishta, and Unmadgajkesri Ras.
Ayurvedic Panchkarma procedures like Shiro-Basti, Shiro-Dhara, Nasya, Basti and full body massage followed by steam fomentation of medicated decoctions, may also be useful in the treatment of epileptic encephalopathies. Medicines like Nirgundi (Vitex negundo) and Dashmool (Ten herbal roots) are especially useful in these procedures. Shiro-Basti involves the retention of medicated oils on the scalp, while Basti involves the use of medicated enemas using oils or decoctions. Several courses of these procedures may be required in patients who are refractory to other treatments.
Ayurvedic herbal medicines can provide an additional as well as supportive role in significantly controlling symptoms, improving quality of life, and increasing the overall life span of affected individuals suffering from these conditions. Ayurvedic herbal treatment thus has a significant role to play in the management and treatment of epileptic encephalopathies.