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Department of Neurology Faculty Papers Department of Neurology

3-1-2012

Old Remedies for Epilepsy: 's Medicine.

A A Asadi-Pooya Department of Epileptology, Research Center for and History of Medicine, Shiraz, University of Medical Sciences; Department of Neurology, Thomas Jefferson University

A R Nikseresht Department of Neurology, Shiraz University of Medical Sciences; Immunology Research Center, Shiraz University of Medical Sciences

E Yaghoubi Department of Neurology, Shiraz University of Medical Sciences

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Recommended Citation Asadi-Pooya, A A; Nikseresht, A R; and Yaghoubi, E, "Old Remedies for Epilepsy: Avicenna's Medicine." (2012). Department of Neurology Faculty Papers. Paper 58. https://jdc.jefferson.edu/neurologyfp/58

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SHORT COMMUNICATION Old Remedies for Epilepsy: Avicenna’s Medicine

AA Asadi-Pooya1,2*, AR Nikseresht3,4, E Yaghoubi3

1Research Center for Traditional Medicine and History of Medicine, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran, 2Department of Neurology, Thomas Jefferson University, Philadelphia, USA, 3Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran 4Immunology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background: The history of epilepsy and its treatments dates back to at least 4 millennia. Avicenna, c. 980 AD in Bukhara, Khorasan – 1037 in Hamedan was a Persian-speaking Iranian , who has many recommen- dations and suggested various therapies for epilepsy in his book, The Canon of Medicine.

Methods: We first reviewed the most important ancient treatments for epilepsy mentioned by Avicenna and considered those as the key words for our next step. Then, we made a literature search (medline and scopus) with those key words to find out new scientific findings in modern medicine about the Avicenna’s suggestions.

Results: Among the Avicenna’s recommended therapies for epilepsy, only Rue has been tested for anticonvul- sant activities in modern medicine. Interestingly, it had a dose dependent anticonvulsant effect.

Conclusion: It is worthwhile to consider the Avicenna’s recommended therapies for epilepsy and to design future scientific studies based on his suggestions.

Keywords: Avicenna; Epilepsy; Treatment

Introduction to treat epilepsy. In spite of these recent advances, a large number of patients continue to have seizures Epilepsy ranks among the most common chronic and many experience adverse effects of treatment. As neurological disorders. The history of epilepsy and its a result, there is an increasing interest in complemen- treatments dates back to at least four millennia, to the tary therapies, including traditional or herbal medi- ancient civilizations of the Middles East. Ancient cine. In this study, we reviewed ancient treatments for contributed an enormous body of epilepsy mentioned by Avicenna and compared them knowledge about seizures, their etiology, their mani- with the recent literature. festations, and treatment. Past treat- ments have usually been empirical, reflecting the clinical observations of the ancient physicians, theo- Materials and Methods logical views or even superstitions. These treatments consisted of prescribed diets or living conditions, me- In this article, we reviewed the most important an- dicinal , and occasionally surgery such as blood- cient treatments for epilepsy mentioned by Avicenna, letting or skull trephination.1 as the master in Iranian ancient medicine, and consid- In the past decades, many new therapies have been ered his suggestions as the key words for the next introduced so that there are various options available step of our study. Then, we made a literature search

with those key words in Medline and Scopus to find

*Correspondence: Ali A. Asadi-Pooya, MD, Associate Professor of out new scientific findings in modern medicine about Research center for Traditional Medicine and History Medicine, the Avicenna’s recommendations, in order to make Department of Neurology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran. Tel: +98- 9352274990, suggestions to design future scientific studies based e-mail: [email protected] on his suggested therapies for epilepsy. Received: August 10, 2011 Accepted: December 12, 2011

Iran Red Crescent Med J 2012; 14(3):174-177 ©Iranian Red Crescent Medical Journal Old remedies for epilepsy

Results A and C, and trace amounts of sulfur and iron. One study indicated that extracts from all plant organs ex- Abu Ali al-Husayn ibn Abd Allah ibn Sina, c. 980 hibited antioxidant activity. The highest antioxidant AD in Bukhara, Khorasan – 1037 AD in Hamedan, activity was observed in the leaves.4 Epidemiologic Iran, also known as Ibn Sina and commonly known in and laboratory studies suggested that allium vegeta- English by his Latinized name Avicenna, was a Per- bles and garlic constituents had antitumor effects.5 sian-speaking Iranian, Muslim polymath and the The probable antiepileptic properties of this plant foremost physician and islamic philosopher of his have never been tested in the modern medicine. time. Avicenna wrote almost 450 treatises on a wide 3- Savory2: Summer savory (Satureja hortensis) is range of subjects, of which around 240 have survived the better known of the Savory species. This has and in particular, 40 of them concentrated on medi- traditionally been used in treatment of cardiovascular cine. His most famous medical work is The Canon of diseases and thrombosis. In one study, it was Medicine, which was a standard medical text at many observed that in addition to alteration of cell adhesive islamic and European until the early 18th properties, self aggregation and protein secretion of century. Avicenna developed a medical system that the treated platelets were also affected upon treatment combined his own personal experience with that of with the crude methanol extract of this plant.6 In islamic medicine, the medical system of the Greek another study, both the ethanolic extract and the physician , and ancient Persian, Mesopotamian essential oil of the plant reversed the oxidative and Indian medicine. Avicenna is regarded as a father damage to rat lymphocytes induced by hydrogen of early modern medicine [pro- peroxide.7 It also has antibacterial, antifungal, and posals/Avicenna/Avicenna - Wikipedia, the free en- antioxidant activities,8 antinociceptive, anti- cyclopedia.mht]. inflammatory effects,9 antispasmodic and anti-diarrheal Avicenna has many recommendations and sug- properties.10 Satureja hortensis has a strong inhibitory gested various therapies for patients with epilepsy in effect on aflatoxin production by A. parasiticus.11 The his book, The Canon of Medicine, some of these in- probable antiepileptic properties of this plant have never clude: been tested in the modern medicine. 4- Wormwood2: Artemisia arborescens (Sheeba in A. Beneficial Therapies for Epilepsy Arabic) is a very bitter herb indigenous to the Middle 1- Rue2: Rue (Ruta) is a genus of strongly scented East. Thujone, camphor and chamazulene account for evergreen subshrubs, in the family Rutaceae. In one about 75% of its oil.12 This plant has antiviral activity study, the effects of an ethanol extract of the aerial against HSV-1 and HSV-2.13 In one animal study, the parts of Ruta chalepensis on the central nervous sys- aqueous extract of this plant caused a concentration- tem (CNS) were studied in mice. A crude extract was dependent reduction in the amplitude of the phasic given systemically and its effects were tested on pen- contractions and in the tone of the ileum.14 This plant tylenetetrazole (PTZ)-induced seizures, sodium pen- has been employed for the treatment of several dis- tobarbital-induced hypnosis, exploratory activity, eases such as malaria, hepatitis, cancer, inflammation anxiety and nociception. A delay in the onset of sei- and infections sustained by fungi or bacteria.13 The zures and a dose-dependent suppression in the tonic probable antiepileptic properties of this plant have phase and mortality induced by PTZ, a prolongation never been tested in the modern medicine. of the time of sodium pentobarbital-induced hypnosis, 5- Dill2: Dill (Anethum graveolens) is a short-lived a significant attenuation in the anxiety-response and a annual herb. This plant has significant lipid lowering reduction in the licking time and shaking behavior in effects.15 Dill has some effects on the female the formalin-induced nociception test have been ob- reproductive system and can be used either as a served. The sedative-hypnotic potentiation, anxiolyt- regulatory agent of the menstrual cycle for women with ic, anticonvulsant and antinociceptive effects sug- irregular cycles or as an antifertility agent.16 It also has gested that Ruta chalepensis induces a depressant ac- antimicrobial activity17,18 and significant mucosal tivity on the CNS.3 protective and antisecretory effects in the gastric 2- Chives2: Chives (Allium schoenoprasum) are mucosa.19 The probable antiepileptic properties of this the smallest species of the onion family. The medical plant have never been tested in the modern medicine. properties of chives are similar to those of garlic. It 6- Hyssop2: Hyssop (Hyssopus) is a genus of containes many organosulfide compounds, vitamins about 10-12 species of herbaceous or semi-woody

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plants in the family Lamiaceae. Hyssop oil is an im- cohol, 2- Overfeeding, 3- Sleep deprivation and 4- portant food additive and .20 Hyssop Oversleeping. is a source of natural antioxidants and its extract may Overfeeding and oversleeping have not been men- inhibit the digestion of complex carbohydrates, but tioned and studied as probable seizure precipitating not that of absorbable monosaccharide, and might be factors in the recent literature. a useful supplemental food for hyperglycemia.21 Hys- sop officinalis extracts exhibit strong anti-HIV activi- ty, and may be useful in the treatment of patients with Conclusions and Recommendations for AIDS.22 The probable antiepileptic properties of this Future Studies plant have never been tested in the modern medicine. 7- Truffle, wild boar meat, phelebotomy, and bal- Among the Avicenna’s recommended therapies for anced diet2 are among other remedies for epilepsy epilepsy, only Rue has been tested for anticonvulsant recommended by Avicenna. The probable antiepilep- activities in modern medicine. Interestingly, it had a tic properties of these have never been tested in the dose dependent anticonvulsant effect. Indeed, nature modern medicine era. has served as a rich source of drugs for centuries and an impressive number of modern drugs have been B. Avicenna's Recommendations with Regard to Sei- derived from natural sources, notably of plant origin. zure Precipitating Factors We believe it is worthwhile to consider the Avicen- Seizures often occur spontaneously without na’s recommended therapies for epilepsy and to de- apparent inciting cause in most individuals, but many sign future scientific studies based on his suggested patients believe that their seizures are precipitated by therapies for epilepsy, as he was a famous scientist external or internal stimuli. Some of these and physician with extraordinary observations and precipitating factors have been well defined in the experiences. recent literature. These include sleep deprivation, excess alcohol intake, premature awakening, psychological stress, prolonged fasting, physical Acknowledgement exhaustion, and photic stimulation.23 Knowing which factors might precipitate seizures could help gain a This work has been supported by a grant funded by better understanding of how some seizures might be Research Center for Traditional Medicine and History avoided in certain individuals. Avicenna has suggest- of Medicine, Shiraz University of Medical Sciences. ed that patients with epilepsy should avoid precipitat- ing factors for seizures, some of those include 1- Al- Conflict of interest: None declared.

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