By: Jeanette Wong
Acupuncture and Epilepsy
What is acupuncture?
Acupuncture is a traditional medical therapy originating in China which involves the insertion of fine needles at specific “acupoints” — meridian points on the body thought to reflect visceral conditions (Li et al., 2015). Applying pressure to these points is believed to regulate the body’s internal organs, controlling one’s pain and other symptoms through the manipulation of qi, a person’s life force or vital energy (Hafner). Historically, acupuncture has been viewed by practitioners and the general public as strictly traditional, a pseudoscience not based on scientific theories. However, growing research has shed light on acupuncture’s efficacy as a possible adjunctive treatment for numerous conditions, allowing the treatment to bypass conventional biomedical models (García-Escamilla et al., 2016). At present, the therapy has been integrated into the medical practice of many Western countries to relieve nerve pain, migraines, menstrual cramps, and many more (Harvard Medical School, 2016). The United States is no exception.
As more practitioners use acupuncture to treat various diseases such as osteoarthritis and other neurological diseases, the combination of anecdotal and evidence-based success, and growing acceptance of the medical community has fuelled the incorporation of acupuncture into the treatment of intractable epilepsy (Millard, 2022). Additionally, acupuncture as an alternative therapy to the adverse side effects of antiepileptic drugs has started to gain traction due to its heightened legitimacy (Millard, 2022). Furthermore, acupuncture is minimally invasive compared to other treatments such as resective surgery. Lastly, undergoing acupuncture allows individuals to avoid disadvantages like the ease of misdiagnosis and the high cost of antiepileptic medications.
How is acupuncture used in epilepsy treatment?
Beliefs surrounding most acupuncture types are built upon the foundational idea that an individual’s unnatural qi flow causes epileptic seizures (Pacific College, 2019). Acupuncture thus aims to restore the qi flow in an individual’s body, hoping to achieve seizure control and eventually seizure freedom. Of the 12 types of acupuncture, the 3 common types of acupuncture that have been explored in epilepsy treatment include: Ancient Traditional Chinese Medicine (TCM) acupuncture, Shamanic (Sham) acupuncture, and catgut implantation (D’Alberto).
In TCM acupuncture, tiny needles, usually made of stainless steel from 0.5-2.5 inches, are inserted into certain acupoints. This allows the therapist to evaluate which meridian points are blocked (Pacific College, 2019). The needles are then manipulated or twirled, with heat or mild electrical pulses applied to them to “unclog” the qi blockages (Mayo Clinic, 2022). The procedure lasts for approximately 20 minutes before the needles are removed (Mayo Clinic, 2022).
Comparatively, needles that look or feel like the needles used in TCM acupuncture are used in Sham acupuncture (National Cancer Institute). These needles are either inserted shallowly away from any acupoints or not inserted into the skin at all (Xiang et al., 2017). Hence, Sham acupuncture is often termed Placebo acupuncture and is invoked as a control experiment for validating the efficacy of TCM acupuncture (Tough et al., 2009).
On the other hand, catgut implantation is an acupuncture subtype during which 1-1.5cm-long catgut cords (usually made from sheep or goat intestine fibers and utilized in surgical procedures) are embedded into specific acupoints with a special needle (Li et al., 2016); (Britannica, 2019). The catgut, which is completely absorbed by the body’s tissue in an estimate of 2-4 weeks, produces a therapeutic effect when stimulated, hopefully attaining a reduction in seizure frequency (Li et al., 2016).
What is the efficacy of acupuncture in epilepsy treatment?
When defining the efficacy of acupuncture treatment in epilepsy care, Western practitioners focus on increasing a patient’s quality of life through the reduction and alleviation of symptoms. This is done by increasing the patient’s probability of attaining seizure freedom, reducing the frequency and duration of seizures, and improving the quality of the individual’s life (Cheuck and Wong, 2014).
However, the efficacy of acupuncture treatment in epilepsy treatment is still under much debate. Past clinical trials have demonstrated the effects of TCM acupuncture treatment in reducing epileptic individuals’ frequency and duration of seizures (Chen et al., 2014). For instance, patients showed an improvement in EEG readings, a reduction in epileptic seizure frequency and duration, and an alleviation of status epilepticus severity, leading to functional recovery (Chen et al., 2014). Moreover, catgut implantation seems to confer higher efficacy than antiepileptic drugs such as Valproate in alleviating epileptic symptoms, with a 50% reduction in seizure frequency (Cheuck and Wong, 2014).
Contrarily, other studies demonstrate the lack of effect TCM acupuncture and Sham acupuncture have in suppressing epileptic seizures (Stavem et al., 2000); (McElroy-Cox, 2009). For instance, there are studies showing that using TCM acupuncture faces a lower probability of achieving seizure control and freedom than using antiepileptic drugs such as Valproate, Phenytoin, or Chinese herbs (Cheuck and Wong, 2014). Despite this, only small population bases have been studied with a high risk of experimental bias across these studies (Cheuck and Wong, 2014); (Stavem et al., 2000). Hence, the clinical efficacy of acupuncture in epilepsy treatment has to be explored more extensively in the future (Schachter, 2008).
Understanding acupuncture in terms of healing: An integrative approach to healthcare
The efficacy of acupuncture, however, should not be limited to the curing of epileptic symptoms. In contrast to Western conceptions of curing, traditional Chinese therapists conceptualize efficacy through the lens of both physiological and psychological healing. This encompasses not just a reduction in epileptic symptoms, but an increasingly positive outlook towards life with improvement in one’s emotional state and social life. This form of efficacy is termed healing — a way to effectively cope with the emotional distress caused by the condition, in this case, epilepsy. As such, healing can be clarified as a symbolic process dependent on the transformation of the body’s experience (Kirmayer, 2004). Hence, the physiological effects and psychological effects of healing via acupuncture are difficult to distinguish. In fact, both forms of healing facilitate the body’s journey to a state of well-being as defined by the individual (Kirmayer, 2004). This makes the process of healing both physical, emotional, and symbolic. Thus, even if acupuncture does not “cure” an individual’s epileptic symptoms, the acupuncture treatment can be viewed as effective if there is a self-reported improvement in quality of life.
This can be demonstrated by how practitioners’ ability to emotionally empathize and connect with patients was the deciding factor in establishing the efficacy of the acupuncture treatment (Barnes, 2005). Though not all patients had their seizure frequency reduced or completely cured, by having their personhood understood and sympathized with, an experience which patients might not gain from biomedical treatment alone, acupuncture enabled patients to feel spiritually and physically healed (Kirmayer, 2004). More so than the insertion and manipulation of qi, the egalitarian exchange of energy and trust between the patient and therapist, empowers the patient to gain control of their bodies momentarily (Barnes, 2005). As TCM acupuncturist McCabe explains, even if one’s symptoms remain stagnant, the patient might experience other aspects of improvement in their well-being (Barnes, 2005).
Additionally, acupuncture can be advantageous in the full scope of patient care, as it is proven to aid in alleviating stress, digestive issues, and sleep disorders — common symptoms issues with epilepsy face (Poyser, 2021). Thus, acupuncture has proven to be effective both as an adjunctive treatment in terms of curing certain symptoms, but also in healing one’s psychological state.
How do I know if acupuncture works for me?
If you decide to try acupuncture as adjunctive therapy to your current treatments, it is important to seek out a licensed therapist to carry out your healing journey. It is essential to note that similar to all other medical treatments, the extent to which acupuncture alleviates epileptic symptoms is relative to each individual (Mayo Clinic, 2022). Nevertheless, taking an integrative approach to epilepsy care can be favorable when analyzing the full scope of patient care and quality of life (Poyser, 2021). Therefore, while epilepsy might be a lifetime condition, finding the right blend of treatments such as taking antiepileptic medication and natural food products together with acupuncture, can be the key to maximizing one’s well-being.
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