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The efficacy of complementary and alternative medicine methods for chronic epilepsy in pediatric patients: A prisma systematic review and meta-analysis

Journal: Unpublished MSc thesis Johns Hopkins University, Date: 2021/07, Pages: 39, type of study: Meta analysis

Free full text   (https://jscholarship.library.jhu.edu/handle/1774.2/64523)

Keywords:

children [228]
epilepsy [7]
meta analysis [43]
OMT [2951]
osteopathic manipulative treatment [2973]
pediatrics [375]
seizures [1]
systematic review [297]

Abstract:

Determining the efficacy of Complementary and Alternative Medicine (CAM) methods for the benefit of clinically diagnosed epileptic patients (ICD-10 code G40, definition found in Appendix) is imperative for developing funding strategies that support these methods, as well as for the success of promoting and improving education about these methods to achieve a truly multidisciplinary field of medicine. Additionally, CAM methods (i.e., ketogenic diets, comprehensive neurobehavior treatment (CNB), yoga, Ayurveda, botanicals, and electroencephalogram (EEG) biofeedback) benefit neurologic patients, the profession, practitioners, researchers, policy makers, and the public at large.1 Even with controlled seizures, epilepsy can present a host of issues that can hinder a child’s development and ability to function normally. Cognitive, behavioral, social, emotional, and other functionalities/abilities critical to normal development are all affected. There is limited research demonstrating efficacy of CAM therapies alone or coupled with that of an antiepileptic drug (AED). Further, it is unclear how consistent use of CAM therapies may impact the overall therapeutic success in pediatric epilepsy in the near future. Dozens of scientific publications exist on CAM methods and the overall impact on epilepsy. However, most of these studies were conducted in the past century and outside of North America, focused on adult patients, and included too few subjects to establish efficacy. With guidance from Covidence, this meta analysis reviewed seven of forty available publications that met the inclusion criteria for pediatric epileptic patients under the age of 25 years old who were treated with CAM therapies and monitored over a 12 month span within the United States between the years 2000 – 2021. All seven studies reported the use of CAM therapies such as keto diets, homeopathy / osteopathy, and comprehensive neurobehavioral treatment. The analysis of those studies revealed a statistically significant reduction in seizures for epileptic children utilizing CAM therapies (p = .0062 and p = .0059). The sample size of subjects was determined by article selection. A total of 671 subjects, calculated from the 7 selected studies, were considered for evaluation. Of these, 388 were excluded as they did not fit criteria for age and seizure duration or discontinued the use of CAM therapy. This exclusion resulted in a remainder of 283 subject participants. All subjects reported ≥ 50% reduction in seizure occurrence per month. Furthermore, 137 subjects (48%) reported complete seizure control. However, limited study size, small population, and a lack of long-term follow-up of treatment for pediatric epilepsy indicate the need for further research and therefore call for additional funding.


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