Anti-seizure effects of medicinal plants in Malawi on pentylenetetrazole-induced seizures in zebrafish larvae

ETHNOPHARMACOLOGICAL RELEVANCE

Medicinal plants are used to manage and treat epilepsy in Malawi because of traditional beliefs and barriers to conventional anti-seizure drugs. Among the plants prescribed by traditional medical practitioners are Margaritaria discoidea, Dalbergia boehmii, Dalbergia nitidula, Catunaregam spinosa, and Lannea discolor. Despite the wide use of these plants, there is a lack of scientific evidence to support their anti-seizure efficacy.

AIM OF THE STUDY

This study used the pentylenetetrazole (PTZ)-induced larval zebrafish seizure model to screen for anti-seizure effects of a collection of medicinal plants traditionally used in Malawi.

MATERIALS AND METHODS

Zebrafish larvae were incubated in decoctions at maximum tolerated concentrations for 18 h and exposed to PTZ. As a primary screen, the effects of the decoctions on seizure-induced locomotor activity were determined. Decoctions that significantly reduced total distance traveled were further checked for effects on seizure latency and frequency, brain activity, immediate early gene expression, and c-fos protein expression.

RESULTS

M. discoidea male leaves, D. boehmii roots, and D. nitidula leaves showed significant anti-seizure effects in the primary screen and were selected for further study. Electrophysiological and immediate early gene analyses corroborated anti-seizure effect of D. boehmii and D. nitidula. The results of c-fos protein expression further suggested that the anti-seizure effects in the larval brain may be mediated by the suppression of neurons localized in midbrain regions.

CONCLUSIONS

These findings provide pioneering scientific evidence of the presence of anti-seizure activity in M. discoidea, D. boehmii, and D. nitidula, prescribed by traditional Malawian medical practitioners. Further studies are needed to identify and isolate compounds responsible for such biological activities and elucidate the possible mechanisms of action.

General side effects and challenges associated with anti-epilepsy medication: A review of related literature

Background

This study is coming against the background of people with epilepsy who are abandoning anti-epilepsy medication in developing countries, such as Zimbabwe.

Aim

The aim of this article was therefore to review the general side effects and challenges associated with these anti-epilepsy medications.

Setting

The researchers reviewed literature related to the general side effects, psychological, social and economic challenges associated with anti- epilepsy medication.

Methods

To answer the research questions, the researchers used a narrative approach.

Results

Findings of the study reflected that the general side effects associated with anti- epilepsy medication include feelings of tiredness, stomach upset, dizziness or blurred vision, which usually happen during the first weeks of taking medicines. Psychologically, an individual with epilepsy may suffer cognitive problems that are associated with thinking, remembering, paying attention or concentrating and finding the right words to use. Socially, people with epilepsy experience social isolation, dependent behaviour, low rates of marriages, unemployment and reduced quality of life. Using anti-epilepsy medication is also associated with economic challenges.

Conclusion

The researchers concluded that some people with epilepsy have discontinued using anti-epilepsy medications because of these side effects and challenges.

Seeking care for epilepsy and its impacts on households in a rural district in southern Malawi

BACKGROUND

Epilepsy is a disability as defined in the 2012 Disability Act of the Government of Malawi.

OBJECTIVES

This article explores the health-seeking behaviour of people with epilepsy in a rural town in southern Malawi and how having a person with epilepsy impacts on the households' productivity.

METHOD

A snowball approach was used to identify persons with various forms of disabilities. The article is based on a bigger study carried out in Malawi which explored how persons with disabilities seek health care. In this bigger study, a total of 63 interviews were done with persons with disabilities or their guardians. Eight of the 63 interviews were with persons with epilepsy and this article is based on these interviews.

RESULTS

The study found that persons with epilepsy seek both traditional and modern medicines to treat the condition. Informants mentioned that barriers to accessing western treatment include lack of medicines, congestion at health facilities, lack of knowledge about epilepsy, misdiagnosis by health workers and the belief that epilepsy caused by witchcraft cannot be treated by western medicine. The study also highlights the wider impacts of epilepsy on the household such as the failure of children to attend school, children dropping out of school, stigma and discrimination and households being driven deeper into poverty as a result of seeking care for members with epilepsy.

CONCLUSION

The existing barriers to accessing treatment for epilepsy can be addressed by using a combination of public education, simple treatments and regular reviews. Ensuring constant availability of drugs for the treatment of epilepsy is key to effective treatment of the condition. This would contribute to closing the treatment gap for epilepsy as advocated by the Global Campaign against Epilepsy.