Epilepsy, A review of current understandings, definitions, treatment, management and osteopathic considerations.
Item
- Title
- Epilepsy, A review of current understandings, definitions, treatment, management and osteopathic considerations.
- Author(s)
- De Berker, J
- Abstract
-
Title: Epilepsy: A Review of Current Understandings, Definitions, Treatment, Management, and Osteopathic Considerations. Introduction: Epilepsy is the next most common neurological condition to stroke and yet it appears that there is Rule in the way of clinical, scientifically precise, evidence based considerations with regards to osteopathic treatment of epilepsy and its associated symptoms, or for the ramifications epilepsy has for osteopathic patient management. The aim of this dissertation is to compile an overview of the current understanding of the mechanics of epilepsy as well as its treatment coupled with prevalence and incidence details with regards to providing a broad knowledge of having epilepsy. It will try to bring in osteopathic considerations and theories for patients in osteopathic practice with regards to both direct treatment of epilepsy, or treatment of individuals who also have epilepsy. Effort will be made to bring in osteopathic thinking and considerations where appropriate and there will be a review of clinical studies and case reports regarding the use of manual therapy for the treatment of epilepsy.Method: A search of following databases will be carried out CINAHL, Cochrane Library, Science Direct, SwetsWise, Wiley Online Library. Using the keywords, epilepsy, prevalence & incidence, seizures, syndromes, treatment, anti-epileptic drugs, side effects, ketogenic diet, comorbidity, autonomic nervous system,complementary and alternative medicine, manual therapy, osteopathy, cranial osteopathy, chiropractic, physiotherapy. Articles looked will date from 1970 onwards due to reviews of older pharmacological treatment that are still relevant today, butmost material will date from 1995 onwards. Content: Epilepsy is a neurological disorder defined by unprovoked synchronous neurological activity, which leads to two or more seizures. It is the most prevalent neurological condition next to stroke and worldwide it is suggested that at least 50 million people suffer with it and there is a 2-3% chance of becoming symptomatic within a lifetime. It is most common in the elderly and in infants and in the UK its incidence is between I in 133 and 1 in 200. There are numerous forms of epileptic seizure, which are broadly divided into generalized and partial syndromes. Pathophysiologically seizures are thought to be the manifestation of a GABA/Glutamate imbalance but the etiology of epilepsy is highly variable and defined as symptomatic, cryptogenic and idiopathic. Although many cases have a known symptomatic (physical) cause, a large number of individuals suffer from idiopathic symptoms. Orthodox treatment usually comes in the form of an anti-epileptic drug, and treatment is achieved in around 60-80% of cases. In those that are refractory to drug therapy the options are surgery in a few select cases, vagal nerve stimulation, and ketogenic diet (which is usually only used with children). Side effects of pharmaceutical treatment are varied, but most notably include alterations to bone mineral density. Individuals may also suffer from comorbidities such as cerebrovascular, cardiovascular and gastrointestinal disorders as well as fracture and diabetes. The autonomic nervous system plays an integral role in displaying epileptic symptoms and seizure often cause sympathetic over rive, sometimes followed by a parasympathetic surge which in extreme cases can lead to heart failure. Case studies show some anecdotal evidence of manual therapy to the cervical spine altering autonomic function and having a positive effect on epilepsy, but information is usually from single case studies, rather than clinical trials.
Conclusion: Manual therapy has little in the way of evidence-based research into epilepsy treatment or management and what Rule research there is, is usually anecdotal. Epilepsy is a broad and wide ranging condition and due to its prevalence greater knowledge could lead to improved management of patients with epilepsy - presented at
- European School of Osteopathy
- Date Accepted
- 2011
- Date Submitted
- 22.1.2013 16:23:35
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 15263
- Inst-Identifier
- 1229
- Keywords
- Epilepsy; Osteopathic management.
- Recommended
- 0
- Item sets
- Thesis
De Berker, J, “Epilepsy, A review of current understandings, definitions, treatment, management and osteopathic considerations.”, Osteopathic Research Web, accessed May 2, 2024, https://www.osteopathicresearch.com/s/orw/item/802