Abstracts

Rationale: Surgery of foci and poly antiepileptic drugs (AED) have been proved to be failure in controlling the frequency and duration of the seizures of intractable epilepsy. Keeping this in view, this study deploys reflexology, together with AED to focus on the study of physical body and mind of the intractable epileptic patients. Methods: Patients were recruited over a period of 2 years from the intractable epilepsy clinic. These were patients who would not benefit from resective epilepsy surgery or lesionectomy. A sample size of 45 – Reflexology arm (22) and AED Polytherapy arm(23) ) suffering from epilepsy for a period of >2years with >2seizures/month while on at least 2 AED with good compliance was recruited in the this trial. After randomization, control arm patients continued treatment from neurologist while the study arm patients received reflexology in addition to pharmacotherapy. In study arm, stimulations on the reflex areas of vagus nerve which had been mapped on the hands, were applied to abort seizure during aura and to reduce the duration of ictal phase. Homeostasis in the internal organ system functions was maintained by stimulating the corresponding reflex areas mapped on the feet. Mechanical stimulations in the form of finger pressure had been applied on each reflex area. The method of applying reflexology technique had been taught to every caregiver and patient. Compliance for therapy was monitored by verbal questioning the patients as well as their caregivers and supervision of therapy sessions as applied by either both of them or the caregivers alone. A record on seizure frequency, duration of ictal phase and the number of times that seizures could be aborted during aura, was maintained. Reduction in seizure frequency up to 25 % was considered as no response, 26%-50% as moderate response, 51%-75% as good response and >75% as excellent response. The primary outcome of this trial was the seizure frequency and the secondary outcome was the quality of life in epilepsy for which QOLIE-31 has been used as the instrument.Results: The results are based on the observations during a monitoring period of 6 months to 2 years. It has been observed that 9 patients (40.9%) had excellent response, 4 (18%) had good response, 8 (36.4%) had moderate response while 1 (4.55 %) had no response compared with pre-reflexology study. There is no prominent change in the seizure frequency of control group samples. The best part of this study is that by stimulating the reflex areas of the vagus nerve, one is able to abort the seizures during aura and to reduce the ictal phase of the seizure. The measurement of quality of life is yet to be calculated in order to conclude the study. Conclusions: This intermediate clinical trial concludes that reflexology can be useful as an adjunct to the pharmacological treatment for managing patients suffering from intractable epilepsy and it certainly merits wider attention as an effective mode of medical therapy for controlling the seizure frequency with an easily available, echo-friendly and simple method.