Oriental Herbal Medicine for Neurological Disorders in Children: An Overview of Systematic Reviews

Abstract

Oriental herbal medicine (OHM) has been widely used in pediatric neurological disorders and has attracted attention as a safe and effective treatment. We aim to summarize and evaluate the evidence for OHM in pediatric neurological disorders for evidence-based decision-making. Without language restrictions, up-to-date research data were obtained from nine electronic databases. Systematic reviews (SRs) assessing the efficacy of OHM for pediatric neurological disorders were included. The methodological quality of each review was assessed using the AMSTAR instrument. The quality of evidence for the main findings was evaluated using the GRADE approach. Sixteen SRs comprising 169 randomized controlled trials with 19,542 participants were included. In epilepsy (six SRs, $n=5,341$ ), OHM as an adjunctive or alternative therapy to antiepileptic drugs showed higher clinical symptom improvements than did antiepileptic drugs alone. The Activities of Daily Living scale score was significantly higher in children with cerebral palsy (one SR, $n=508$ ) when OHM was added to rehabilitation. There were inconsistent results for tic disorder (four SRs, $n=9,870$ ) and enuresis (two SRs, $n=1,995$ ) and unclear results for attention deficit hyperactivity disorder (two SRs, $n=1,261$ ) and autism spectrum disorder (one SR, $n=567$ ). Eleven SRs reported adverse events, but no fatal adverse reaction was reported. The methodological quality of the included reviews was medium-to-high. The overall quality of evidence ranged from "very low" to "moderate." In conclusion, the efficacy of OHM is promising for some pediatric neurological disorders such as epilepsy and cerebral palsy. However, more high-quality evidence is needed to make clinical recommendations on OHM use.

Keywords: Child; Neurological Disorder; Oriental Traditional Medicine; Overview; Systematic Review.