Abstracts

Rationale: Epilepsy is a common neurological disorder. India has about 5 million people patients suffering from epilepsy. Despite advances in therapy, about 20-30% of the patients of epilepsy remain refractory to treatment. In India economic constraint is a major issue which calls for alternate cost effective treatments. Reflexology is a non-pharmacological, low cost therapy that has been described to have some anti-seizure effect. The present study has examined the efficacy of Reflexology therapy in combination with the conventional drug therapy in the management / cure of cases of intractable epilepsy. Methods: Only patients suffering form epilepsy for more than two years with more than two seizures per month while on at least two anti-epileptic drugs with good compliance and ruling out the occurrence of pseudo-seizures, were included in the study. Patients were randomly assigned to the study arm receiving combination of Reflexology therapy and conventional therapy and the control arm receiving only the conventional therapy. The seizure type, frequency and duration along with bio-chemical, physiological parameters and other investigations were recorded before starting therapy, half way through the therapy protocol and after completion of therapy. Patients having 25% to 50%, 50% to 75% and 75% to 100% reduction in seizure frequency were categorized as having mild, moderate and excellent response respectively. The total protocol for treatment in the study arm was 3 months. As per the protocol designed for Reflexology, therapy the number of reflex areas on the feet that were stimulated was gradually increased every week until the end of 10 week when all the steps were completed. The duration of therapy was gradually increased from 10 minutes twice a day on the first day to half an hour twice a day by the end of 10th week. The post-therapy response to the study protocol was observed at the end of 12 weeks. Thereafter the patients were on regular follow-up. Results: The age of the patients in the control arm; mean + SD: 21.9 + 12.0, and the age in the study arm; mean + SD: 23.2 + 13.2 was statistically comparable. Pre - therapy seizure frequency in the control group; median 17, range 1 - 700 and the pre - therapy seizure frequency in the study arm; median 13.5, range 1 - 760, was also comparable. Post - therapy seizure frequency was significantly lower in the study arm; median 2, range 0 to 210, as compared to the control arm; median 3.5, range 1 to 670 (p = 0.0001, Wilcoxon rank sum test). Conclusions: There was statistically significant reduction in the frequency of seizure in the conventional and reflexology therapy group as compared to the conventional therapy group alone. The results of the study suggest a promising role for reflexology therapy in the management of epilepsy. There is a need to carry out large multi-centre studies to confirm these results.