Abstracts

Rationale: It has been suggested that magnetic wrist bracelets may be effective in control of epileptic seizures. Anecdotal reports from patients and from alternative practitioners claim that this treatment is extremely effective. As conventional physicians we are sceptical of these claims, but we feel that it is essential that any such treatment should be tested in appropriate scientific studies. Methods: The study was a double blind placebo controlled cross over, on adult residents, at a large epilepsy centre in the UK. All residents have ongoing accurate seizure records. All subjects had medically intractable epilepsy with a range of seizure types, with a minimum of 2 seizures per month and no 28 day seizure free period in the previous 6 months, all were on stable medication, with no recent changes. Subjects had two eight week periods with either control or active wrist magnets, then crossing over, for a further eight week period. The manufacturer supplied magnets in numbered pairs, one of each pair a magnet, the other dummy. The bracelets were coded, the subjects were randomized to dummy bracelet first, a magnet second, or magnet first, a dummy bracelet second. Investigators and care staff were blinded to allocation. Normal seizure recording was continued, and the seizure frequencies analyzed after the second period. Codes were retained by the manufacturer until after data collection was completed. As not all subjects wore the magnets (protocol violations mainly on account of subject's intellectual handicap), data was analysed both on an "intention-to-treat" (ITT) and "per-protocol" (PP) basis. The null hypothesis is that wrist magnets do not affect seizure frequency; the data was pooled and analyzed using StatsDirect with a paired one sided Students t-test. The study had local ethical committee approval. Results: 42 patients were studied, 35 wore the magnets. ITT analysis (n=42): during 8 week control period mean 41.2 seizures (median 17.5), during treatment period mean 49.2 (median 19.5),P=0.077. PP analysis (n=35): during 8 week control period mean 45.3 seizures (median 19), during treatment period mean 54.8 (median 19),P=0.074. There was no significant difference, between dummy and active magnet treatment, on seizure frequency; in fact the use of a magnet bracelet resulted in a non-significant trend to more seizures. Conclusions: The use of magnetic bracelets had no effect on epileptic seizure frequency. Many patients with epilepsy turn to complementary or alternative medicine(CAM), either because conventional treatments are ineffective, or cause side-effects, or due to lack of confidence in conventional medicine. Most CAM is unregulated and untested; we believe that were possible these treatments should be subjected to appropriate study.