Epileptic Children’s Seizures Reduced with Medically Supervised Diet

Although not without side effects, and nothing to try on your own at home, there is a serious medical treatment, that has recently been shown to help two out of three children who suffer from epilepsy and to completely prevent seizures in one out of three. It is known as the ketogenic diet.

Although diet, at first glance, may seem like a more "natural" way than taking medication to prevent seizures, this diet actually involves eating a highly unnatural selection of foods that, in effect, reverses the body's natural system of using food to produce energy. The diet consists of specialized meals where small amounts of fruits or vegetables (carbohydrates) are served with meat, fish, or chicken (protein), and includes heavy use of fat in the form of butter, eggs, mayonnaise and cream. The diet allows absolutely no sugar. Portions are small because calories are strictly controlled to provide enough to maintain normal weight, but not so many that the high fat menu will cause weight gain, as it normally would.

It is believed that the high fat and limited carbohydrate content of the diet forces the body into a kind of starvation mode where the body burns fat for energy instead of glucose. Carbohydrates are so scarce in the diet that energy must be obtained from breaking down fatty acids. These metabolism by-products, called ketone bodies, provide energy to the heart and brain.

Food on the diet must be worked out individually for each child, and portions must be weighted and prepared very carefully, to the extent of even using a gram scale. Any tiny mistake in measurement, or weighing of the food, or if the child should eat anything that contains sugar, or even use something as simple as a toothpaste or cough syrup that contains sugar, and the effects of the diet will be negated, and the action could result in a seizure.

Difficult as this diet is, a recent University College London study that will appear in the June, 2008, issue of The Lancet Neurology, has found that the diet, high in fat, low in carbohydrates, and with controlled protein intake, is effective in controlling and preventing seizures in children who have drug-resistant epilepsy.

The recent study included 145 drug-resistant children, ages 2 to 16, who suffered seizures at least once daily, or more than seven times per week. Over a three month period complete data was obtained from 54 children who had been placed on the ketogenic diet at the start of the study, and from 49 children who had been used as a control group, and had not been started on the diet.

At the end of the trial, seizures in the diet group had declined by more than 38 percent, while seizures in the control group had increased by 36.9 percent. Twenty-eight of the children in the diet group had a greater than 50 percent reduction in their seizures, while only four children in the control group experienced such a reduction. Five children in the diet group had more than 90 percent fewer seizures; none in the control group achieved that high a percentage of improvement.

It should be noted that even with perfect management some children will suffer side effects such as dehydration, constipation, or complications from kidney or gall stones when on the diet. Careful medical monitoring is necessary to be sure high levels of fat do not build up in the blood, and parents need to be diligent in checking the child's ketone levels by the use of paper strips to test the urine. The diet is vitamin deficient, so vitamin supplements are necessary.

This is not a lifetime diet, and often there is a period of fine-turning necessary, taking from one to three months. Children who can tolerate the diet usually stay on it about two years and then go back to their normal eating habits, sometimes with just a little seizure medicine. Many are able to remain seizure free after stopping the diet, and if not the doctor may suggest starting the diet again.

Warning: This diet can never be safely tried on your own. It is NOT, in any way, a do-it-yourself diet. It requires a team of medical professionals, who are skilled in its use, and who will consistently monitor for side effects on a continuing basis. It must be started in a medical facility that specializes in this type of therapy, or in a hospital setting under strict medical supervision. The risks and rewards of the diet should be carefully discussed and assessed before beginning, for it is a major commitment for both parents and children.