432 Pediatric acupuncture reduction in number of wet nights). Similarly, in the acupuncture group, 65% of the children remained com- pletely dry at 6 months and 10% were partial responders. Considering the spontaneous cure rate of 15% a year among enuretic populations, these findings suggest a role for acupuncture as an alternative treatment option for families. An earlier study (56) examined 25 children, aged 7–16 years, who had previously been treated for nocturnal enuresis. Children underwent 20 sessions of electro- acupuncture, in which pre-selected regions were manually stimulated, and/or stimulated through painless low fre- quency biphasic pulses. At the 6-month follow-up, five of the children were considered responders ( 90% reduction in number of wet nights) and six were deemed partial responders ( 50% reduction in number of wet nights). Although a majority of children were non-responders at 6 months, 65% of the sample experienced an increase in dry nights such that the median numbers of dry nights increased from 2.3 to 5.0 dry nights per week. A more recent study examined 15 children, aged 6–18 years, with nocturnal enuresis (57). Participants received four weekly sessions of acupuncture in pre-selected acupoints. Findings revealed that 20% of children were deemed cured ( 90% reduction in number of wet nights), while another 20% showed clinical improvement ( 50% reduction in number of wet nights) immediately after intervention. In addition, at the 2-month follow up, 47% of the sample was deemed cured. A similar study conducted among 50 children with nocturnal enuresis, aged 9–18 years, found 86% of participants experienced no bedwetting at a 6-month follow up (58). In addition, Korean hand acupuncture for children with nocturnal enuresis has been examined in a double- blind, placebo controlled, crossover study among 26 children, aged 5–13 years (59). A reduction of wet nights was observed under both active and sham Korean hand therapy conditions, however, more children improved while undergoing active treatment. A total of 53% of participants experienced 90% dry nights at 3-month follow-up. However, outcome measurements and statis- tical findings were not clearly defined in this study. Although pharmacotherapy is highly effective among children with enuresis, parents are often hesitant to initiate pharmacological treatments. Therefore, beha- vioral strategies, including alarm therapy and bladder stretching exercises, have been employed and often used in conjunction with medication (60,61). As the efficacy of acupuncture continues to be explored, its use as an alternative treatment option for enuresis among children and adolescents appears to be gaining validity. Constipation Only one study has investigated the use of acupuncture for the treatment of childhood constipation (62). Twenty-seven children, aged 3–13 years, who had been experiencing constipation for at least 6 months were initially enrolled in the study, however, 10 children were excluded due to poor compliance. Fifteen children, aged 2–14 years, who did not experience any gastrointestinal difficulties, comprised the control group. Participants initially received five weekly placebo acupuncture session in which needles were inserted into the stratum corneum near the actual acupoints. Following the placebo intervention, participants under- went 10 weekly acupuncture sessions through subdermal needling. Both males and females showed a similar significant increase in number of bowel movements per week after 10 weeks of acupuncture, however, females tended to improve more quickly. In fact, female partici- pants began to display improvements after the initial 5-week placebo acupuncture trial. This study holds promise for the role of acupuncture in the treatment of pediatric constipation, yet more research is clearly needed to replicate these findings. Epilepsy The Cochrane Collaboration recently published a review of acupuncture research in the treatment of epilepsy (63), however only one study examined a pediatric sample. Specifically, Xiong (64) published a study in China that assessed 64 boys, aged 1–17 years, with epilepsy. Participants were randomized into one of three groups: fixed point acupuncture and Chinese herbs, Chinese herbs alone, or carbamaxepine alone. Findings revealed a <50% reduction in seizure frequency in 90%, 80% and 73% of participants in the three treatment groups, respectively. However, this did not represent a statisti- cally significant difference in improvement between groups. Furthermore, acupuncture plus herb treatment did not statistically differ in terms of the length of seizures or EEG normalization as compared with the herb or carbamazepine treatment alone. In conjunction with these non-significant findings, the Cochrane review concluded that there was no strong evidence for acupuncture as a treatment for epilepsy. Allergies Despite the fact that only one randomized trial has been conducted in the adult literature, 5% of adults with allergic rhinitis in the United States have reportedly used acupuncture to alleviate their symptoms (65,66). Similarly, only one randomized study has been conducted to assess the effects of acupuncture on pediatric allergic rhinitis. Ng and colleagues (67) conducted a double blind, randomized, placebo controlled study among children in a Hong Kong Hospital with persistent allergic rhinitis. Seventy-two children, aged 6–20 years, were assigned to receive acupuncture or sham acupuncture, where needles were inserted only 0.3 cm into the skin and were not