TY  - BOOK
AU  - Mohammad Hadi Nematollahi
AU  -  Seyed Ebrahim Mansourinejad
TI  - Efficacy of a traditional herbal formula against drug-resistant childhood epilepsy
KW  - Anacyclus pyrethrum
KW  - Child
KW  - Drug-resistant epilepsy
KW  - Paeonia lactiflora
KW  - Traditional medicine
N2  - In  about  one-quarter  of  childhood  epilepsies,  there  is  no  complete  response  to  the  routine,  available  antiepileptic  drugs  (AEDs).  In  traditional  Persian  medicine  (TPM),  Paeonia  lactiflora  and Anacyclus  pyrethrum  have  been  known  for  their  anticonvulsant effects. The aim of this study was to evaluate the therapeutic efficacy of a combined herbal formula consisting of the dried root of P. lactiflora and A. pyrethrum in childhood drug-resistant epilepsy (DRE). This single-arm before/after clinical trial  was  conducted  on  46  children  with  DRE.  The  patients  were  observed  for  three  months  before  as  well  as  thirteen  weeks  after the administration of this traditional herbal preparation at a dose of 15 mg/kg/day. The frequency and duration of seizures were  evaluated  using  the  Hague  seizure  severity  scale  (HASS).  There  was  a  statistically  significant  reduction  in  both  the  frequency and duration of seizures after treatment with the herbal preparation (p-values were <0.001 and <0.05, respectively). A  statistically  significant  response  to  the  herbal  formula  started  after  eight  weeks  of  treatment.  The  traditional  formula  of  P. lactiflora and A. pyrethrum could be considered as a complementary medicine for treating childhood DRE. However, furtherstudies  are  needed  to  provide  more  evidence  of  its  benefits  and possible harms and also determine the precise mechanisms ofaction of this formula as a medicinal remedy for epilepsy.Keywords: Anacyclus pyrethrum, Child, Drug-resistant epilepsy, Paeonia lactiflora, Traditional medicine IPC Code: Int Cl.24: A61K 36/00Epilepsy  is  one  of  the  most  common  neurological  diseases1,2.  Approximately  a  quarter  of  children  with  epilepsy show varying degrees of drug resistance called “intractable”  or  “refractory”  epilepsy.  Drug-resistant  epilepsy (DRE) has been defined as a persistent seizure activity despite adequate trials of at least two tolerated and  appropriately  chosen  antiepileptic  drugs  (AEDs)3. DRE  affects  all  aspects  of  a  child’s  development,  leading  to  significant  impairment  in  quality  of  life,  as  well as behavioral and psychiatric problems, including depression,  sleep  and  mood  disorders,  cognitive  delay,  and  poor  scholastic  performance4.  Moreover,  some  patients   experience   unacceptable   AED-related   side   effects,     such     as     teratogenicity,     liver     toxicity,     gastrointestinal  complications,  etc5.  In  general,  drug  resistance   and   interactions,   high   costs,   and   AED-related  side  effects  are  the  main  challenges  in  drug  administration, particularly in children6. Therefore,  the  need  for  complementary  therapies  with fewer side effects is evident. Traditional Persian medicine  (TPM),  which  is  based  on  thousands  of  years  of  experience,  has  provided  effective  therapies  in  this  regard7-9.  A  combined  herbal  formula  of  the  dried  roots  of  Paeonia  lactiflora  Pall.  and  Anacyclus pyrethrum  DC.,  has  been  used  for  the  treatment  of  epilepsy in TPM10-12. Although numerous studies have evaluated  the  antiepileptic  properties  of  various  plant  components,  few  studies  have  evaluated  the  efficacy  of  these  herbal  remedies  in  clinical  trials.  The  aim  of  the  current  study  was  to  evaluate  the  efficacy  of  the  —————*Corresponding author

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