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Acupuncture for epilepsy

Cheuk DKL, Wong V
Published Online: 
7 May 2014

People with epilepsy are currently treated with antiepileptic drugs but a significant number of people continue to have seizures and many experience adverse effects to the drugs. As a result, there is increasing interest in alternative therapies and acupuncture is one of those. Seventeen randomised controlled trials with 1538 participants were included in the current systematic review (literature search conducted on 3rd June 2013).

Compared with Chinese herbs, needle acupuncture plus Chinese herbs was not effective in achieving satisfactory seizure control (at least 50% reduction in seizure frequency). If we assumed that 500 out of 1000 patients treated with Chinese herbs alone normally achieved satisfactory seizure control, we estimated that 485 to 655 out of 1000 patients treated with needle acupuncture plus Chinese herbs would achieve satisfactory seizure control. Compared with valproate, needle acupuncture plus valproate was not effective in achieving freedom from seizures or satisfactory seizure control. If we assumed that 136 out of 1000 patients treated with valproate alone normally achieved seizure freedom, we estimated that about 97 to 177 out of 1000 patients treated with acupuncture plus valproate would achieve seizure freedom; if we assumed that 556 out of 1000 patients treated with valproate alone normally achieved satisfactory seizure control, we estimated that about 289 to 1000 out of 1000 patients treated with acupuncture plus valproate would achieve satisfactory seizure control. Compared with phenytoin, needle acupuncture was not effective in achieving satisfactory seizure control. If we assumed that 700 out of 1000 patients treated with phenytoin alone normally achieved satisfactory seizure control, we estimated that about 322 to 1000 out of 1000 patients treated with acupuncture alone would achieve satisfactory seizure control. Compared with valproate, needle acupuncture was not effective in achieving seizure freedom but it may have been better in achieving satisfactory seizure control. If we assumed that 136 out of 1000 patients treated with valproate alone normally achieved seizure freedom, we estimated that about 126 to 445 out of 1000 patients treated with acupuncture alone would achieve seizure freedom; if we assumed that 556 out of 1000 patients treated with valproate alone normally achieved satisfactory seizure control, we estimated that about 583 to 923 out of 1000 patients treated with acupuncture alone would achieve satisfactory seizure control. Compared with antiepileptic drugs, catgut implantation at acupoints plus antiepileptic drugs was not effective in achieving seizure freedom, but it may have been better in achieving satisfactory seizure control. If we assumed that 127 out of 1000 patients treated with antiepileptic drugs alone normally achieved seizure freedom, we estimated that about 118 to 309 out of 1000 patients treated with catgut implantation at acupoints plus antiepileptic drugs would achieve seizure freedom; If we assumed that 444 out of 1000 patients treated with antiepileptic drugs alone normally achieved satisfactory seizure control, we estimated that about 475 to 840 out of 1000 patients treated with catgut implantation at acupoints plus antiepileptic drugs would achieve satisfactory seizure control. Compared with valproate, catgut implantation may have been better in achieving seizure freedom but not satisfactory seizure control. If we assumed that 82 out of 1000 patients treated with valproate alone normally achieved seizure freedom, we estimated that about 132 to 406 out of 1000 patients treated with catgut implantation at acupoints alone would achieve seizure freedom; if we assumed that 721 out of 1000 patients treated with valproate alone normally achieved satisfactory seizure control, we estimated that about 677 to 1000 out of 1000 patients treated with catgut implantation at acupoints alone would achieve satisfactory seizure control.

Acupuncture did not have excess adverse events compared to control treatment in the included trials. However, the included trials were small, heterogeneous and had a high risk of bias. It remains uncertain whether acupuncture is effective and safe for treating people with epilepsy.