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Background: Epilepsy affects around 50 million people worldwide, and about one-third of patients do not achieve seizure control with available antiseizure medicines. Ayurveda describes epilepsy as Apasmara, literally “loss of memory or awareness”, and prescribes purification, medicated ghee formulations and Medhya herbs for its management. Objective: To review the classical concept and management of Apasmara and the preclinical and clinical evidence for herbs and formulations used in its treatment. Methods: Narrative review of Charaka Samhita and Sushruta Samhita and of experimental and clinical studies identified through PubMed, Google Scholar and Indian databases. Results: Classical texts describe four types of Apasmara according to Dosha, with clear descriptions of aura, convulsions, loss of consciousness and post-ictal states, and recommend Shodhana followed by medicated ghee preparations such as Brahmi Ghrita and Panchagavya Ghrita. Preclinical studies show anticonvulsant effects for Jatamansi in the maximal electroshock model, with synergy with phenytoin; for Ashwagandha root extract through GABA-related mechanisms and in pilocarpine-induced seizures; for Vacha in electroshock and pentylenetetrazol models; and for a marketed Brahmi Ghrita in pentylenetetrazol seizures. Clinical evidence is very limited. A Cochrane review found only low-certainty evidence that yoga may reduce seizure frequency. Conclusion: Several Ayurvedic herbs show anticonvulsant activity in animals and deserve further study, particularly as adjuncts to standard antiseizure medicines. Clinical use as a replacement for standard treatment is not supported. Herb–drug interactions and product quality must be considered.

Keywords: Apasmara; epilepsy; anticonvulsant; Medhya Rasayana; Brahmi Ghrita; Jatamansi; Ashwagandha; Vacha