Acupunctuur voor epilepsie

BACKGROUND: Acupuncture in increasingly used in people with epilepsy. It remains unclear whether existing evidence is rigorous enough to support its use. This is an update of a Cochrane review first published in 2006. OBJECTIVES: To determine the effectiveness and safety of acupuncture in people with epilepsy. SEARCH STRATEGY: We searched the Cochrane Epilepsy Group's Specialised Register (June 2011) and the Cochrane Central Register of Controlled Trials (CENTRAL issue 2 of 4, The Cochrane Library 2011), MEDLINE, EMBASE, and other databases from inception to June 2011. We reviewed reference lists from relevant trials. We did not impose any language restrictions. SELECTION CRITERIA: Randomised controlled trials comparing acupuncture with placebo or sham treatment, antiepileptic drugs or no treatment; or comparing acupuncture plus other treatments with the same other treatments, involving people of any age with any type of epilepsy. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted trial data and assessed trial quality. MAIN RESULTS: Sixteen trials (15 in China and 1 in Norway) with 1486 participants met the inclusion criteria. Compared with control treatment, needle acupuncture was not effective in reducing seizure frequency (five trials). Compared with phenytoin (two trials), needle acupuncture may be better in achieving at least 75% or at least 25% reduction in seizure frequency. Compared with valproate (two trials), needle acupuncture may be better in achieving at least 50% or at least 75% reduction in seizure frequency, better quality of life (QOL), lower frequency of impaired concentration, and higher likelihood of at least 70% improvement in epilepsy score. Compared with antiepileptic drugs (four trials), catgut implantation at acupoints may be better in achieving at least 50% reduction in seizure frequency. However, there was significant heterogeneity in this outcome. Catgut implantation may be better in achieving at least 75% or at least 25% reduction in seizure frequency, at least 70% or at least 40% improvement in epilepsy score, better quality of life and lower frequency of dizziness or impaired concentration. Compared with valproate alone (five trials), catgut implantation may be better in achieving seizure freedom or at least 75% reduction in seizure frequency. However, there was significant heterogeneity in the latter outcome. Catgut implantation may be better in achieving at least 25% reduction in seizure frequency and improvement in epilepsy score, QOL, and lower frequency of anorexia. All included trials had high risk of bias with short follow-up. AUTHORS' CONCLUSIONS: The current evidence does not support acupuncture for treating epilepsy.