Can Ginkgo Biloba Help Epilepsy Patients? A Neurology Perspective

Epilepsy patients taking ginkgo products?

Hello, Doctor.
I have been suffering from absence seizures since I was 8 years old, which has lasted for 31 years.
It is not hereditary, and I have not experienced any head trauma; the cause of my condition remains unknown.
I have tried medication treatment twice, and the last treatment lasted over a year more than a decade ago.
The side effects of the medication were so severe that they affected my daily life (daily double vision, dizziness, lethargy, unsteady gait, and nausea), and the frequency of my seizures increased from over 20 times a day to over 40 times a day, leading me to ultimately discontinue treatment.
I have undergone MRI scans, which showed no abnormalities.
(Medications I have taken include: Dilantin, Depakote, and Lamictal.) Currently, when my physical and mental condition is good, I may have a seizure every few days; when my condition worsens, I can have more than 10 seizures in a day.
Approximately every six months, I experience a sudden increase in seizure frequency for 3 to 7 days without any known reason, with up to 40 to 50 seizures in a single day.
Each seizure lasts about 10 seconds.
On regular days, I do not feel any significant damage to my brain after a seizure.
However, during those 3 to 7 days of increased seizure activity, I clearly experience memory decline, inability to concentrate, cognitive difficulties, and slight speech difficulties.
Usually, after the period of increased seizures ends, I take a few days of Ginkgo biloba (two capsules a day), which helps me immediately restore my memory, clarify my thoughts, and alleviate the feeling of head heaviness.
Recently, I have seen reports indicating that epilepsy patients should avoid Ginkgo products, as they may trigger seizures.
I would like to ask: 1.
If I have not experienced an increase in seizures due to taking Ginkgo products so far, can I continue to take them for a short period of a few days? 2.
A doctor once mentioned that it usually takes a few months to adapt to the side effects, but I have not seen any improvement in side effects for over a year.
I really want to cure my condition, but the side effects of the medication affect my daily life more than the seizures themselves.
Are there any new treatment methods or medications with fewer side effects that have emerged in the past 15 years for patients with poor medication control of epilepsy? Thank you!

Niming, 40~49 year old female. Ask Date: 2013/05/04

Dr. Gao Chunde reply Neurology

Ginkgo biloba extract can improve attention, memory, and dizziness, particularly in relation to peripheral circulation disorders.
After brain electrical activity, there is a period of decreased blood flow, which may coincide with the improvement you experience after taking your medication.
There are case reports suggesting that ginkgo biloba extract may increase the likelihood of seizures, hypothesized to be due to altered metabolism of antiepileptic drugs through liver enzymes, and animal studies have shown a reduction in the seizure threshold.
As for the duration of intake, whether it be five days or two weeks, there is no definitive answer; generally, a shorter duration is preferable.
Regarding your second question, there have been significant advancements in epilepsy treatment over the past fifteen years, including medications, surgery, and even vagus nerve stimulation.
It is advisable to seek an appointment with a specialized epilepsy clinic at a medical center to consult with an expert in this field, as frequent electrical discharges in the brain can lead to some degree of damage over time, which is concerning in the long run.

Reply Date: 2013/05/04

More Info

Epilepsy is a complex neurological disorder characterized by recurrent seizures, and its management can be particularly challenging, especially for patients who have not responded well to conventional treatments. Your experience with epilepsy, particularly with the side effects of antiepileptic drugs (AEDs), is unfortunately not uncommon. Many patients face similar issues, where the side effects of medications can significantly impact their quality of life, sometimes even more than the seizures themselves.

Ginkgo Biloba and Epilepsy
Regarding your question about Ginkgo Biloba, it is important to note that while Ginkgo Biloba is often marketed as a natural supplement that may enhance cognitive function and improve blood circulation, its use in epilepsy patients is controversial. Some studies suggest that Ginkgo Biloba may have neuroprotective effects, but there is also evidence indicating that it could potentially lower the seizure threshold in some individuals, leading to an increased risk of seizures.
1. Short-term Use of Ginkgo Biloba: If you have not experienced an increase in seizure frequency while taking Ginkgo Biloba, it may be reasonable to continue its use for a short period. However, it is crucial to monitor your condition closely. If you notice any changes in your seizure patterns or experience any adverse effects, it would be wise to discontinue its use immediately. Always consult with your healthcare provider before starting or continuing any supplement, especially given your history of epilepsy.

2. New Treatment Options: The field of epilepsy treatment has evolved significantly over the past decade. While traditional AEDs like Valproate (Depakine) and Lamotrigine (Lamictal) are still widely used, there are newer medications available that may have a better side effect profile. Some of these newer AEDs include:
- Lacosamide (Vimpat): This medication is used for partial-onset seizures and has a relatively favorable side effect profile.

- Eslicarbazepine acetate (Aptiom): Another newer option that may be beneficial for patients with partial seizures.

- Perampanel (Fycompa): This is a newer AED that has been shown to be effective for partial and generalized seizures, and it may have fewer cognitive side effects compared to older medications.

In addition to pharmacological treatments, there are also non-pharmacological approaches that may be beneficial for patients with refractory epilepsy:
- Ketogenic Diet: This high-fat, low-carbohydrate diet has been shown to reduce seizure frequency in some patients, particularly children with refractory epilepsy.

- Vagus Nerve Stimulation (VNS): This treatment involves implanting a device that stimulates the vagus nerve and can help reduce seizure frequency in some patients who do not respond to medications.

- Responsive Neurostimulation (RNS): This is a newer treatment option that involves implanting a device that detects abnormal electrical activity in the brain and delivers electrical stimulation to prevent seizures.

Conclusion
In summary, while Ginkgo Biloba may not have caused an increase in your seizures thus far, caution is advised due to the potential risks associated with its use in epilepsy patients. It is essential to have open discussions with your neurologist about your treatment options, including the possibility of newer medications or alternative therapies that may better suit your needs and lifestyle. Your quality of life is paramount, and finding a treatment plan that minimizes side effects while effectively controlling seizures is the ultimate goal. Always prioritize communication with your healthcare provider to ensure that any changes in your treatment plan are safe and appropriate for your specific situation.

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