In the previous blog you have read about the overall health benefits of keto diet. In this blog we will discuss specifically about the ketogenic diet and epilepsy. Dr. Russel Wilder, a researcher in diabetes and nutrition was the one who used this diet. He emphasized the benefits of keto diet in treatment of patients with epilepsy.
What Is Epilepsy
Epilepsy is a neurological disorder. In this the patient experiences involuntary and repetitive body movements called seizures. This happens due to chemical derangements and other pathological processes in brain. Physical symptoms can range from muscle spasms to loss of consciousness and abnormal mental behavior.
A person is diagnosed with epilepsy when he or she has two or more episodes over a period of 24 hours. Studies have shown that epilepsy is more prone in young children and elderly as compared to young adults.
About one third of people with epilepsy live with seizures because no treatment works for them, as per Epilepsy Foundation. Here is the list of medications that doctors prescribe in treatment of epilepsy (Source WebMd).
Keto Diet and Epilepsy History Peek
It all started in 1924 at the renowned Mayo Clinic. There Dr. Russel Wilder developed this low carbs diet for the treatment of epilepsy in children. There are reports of it being highly effective back then too. However in 1940s, when medication became available for seizures, the use of keto diet declined.
Keto diet gained its fame back in 1944. Now, this low carb and high fat diet is a well know treatment option with doctors and dieticians to treat epilepsy. But it is also useful in children who don’t respond to conventional treatment.
The first landmark research study was a randomized controlled trial, published in 1998 in the Journal of Pediatrics. which involved 150 children ranging from 1 to 16 years. This study assess the benefits of the keto diet in children and adults with seizures.
Nearly all of them had more than two seizures per week despite taking at least two anti-epileptic medications. These children were fed with ketogenic diet for one-year. They assessed the children’s seizure frequency and compliance with the diet at regular intervals and after a period of one year.
After three months of starting the diet, 83% of the patients remained diet complaint. Approximately 34% of the children experienced a 90% decline in seizure episodes. After 6 months, 71% of the children remained on the ketogenic diet and 32% had over a 90% decline in seizures.
After completing one year, 55% remained on the diet and 27% had a 90% decline in seizure episodes. This study provides a strong evidence that ketogenic diet was highly effective in keeping seizure episodes under check in a sizable number of children.
Keto Diet Rules In Epilepsy Patients
The basic keto diet rule is to achieve 4:1 ratio, which includes four portions of fat to one portion of carbohydrates plus proteins. There are two practical approaches to achieve this. One with fasting and second without fasting.
With fasting approach, the patient stays in hospital for at least 12-48 hrs. It helps to avoid any adverse events like hypoglycemia and dehydration. Fasting depletes glycogen stores and forces the body to utilize fat as the main energy source. This utilization of fat accelerates ketone production. After reaching ketosis, a doctor or a dietician calculates the diet to maintain ketone levels.
With the second approach, there is no need of hospitalization. Ketosis is achieved gradually over a period of weeks. The keto diet ratio is increased weekly, from 1:1, 2:1, 3:1 to 4:1. This approach is more practical and is more common among keto diet followers.
If you are planning of going on a keto diet then it’s important that you should start with multivitamin and mineral supplements.
Side Effects Of Keto Diet And Follow Up
Epileptic patients on Keto diet should undergo a routine follow up every 3 months with the doctor and certified dietician. Although some authors have reported no relationship between the efficacy and the level of ketosis. But it is still recommended to measure the urine ketosis several times a week.
For efficacy, the KD requires a period of at least 3 months from the time that the patient reaches ketosis, so it is important to encourage the patient and the family to continue with the diet for this period without changing the medication.
Patient and family members should be educated about the side effects of keto diet like hypoglycemia. They should be advised to administer a small amount of juice or other forms of sugars, if required. Kidney stones (Nephrolithiasis) may also develop in some individuals. An abdominal ultrasonography is the test of choice if patient complains of abdominal or flank pains.
Ketogenic diet is highly effective option for epilepsy in children who don’t respond to traditional anti-epileptic drugs. If conventional treatment is not helping you or your child in lowering the frequency of seizures, strongly consider using ketogenic diet.
Remember, always discuss a suitable plan with your doctor and a registered dietitian. Ketogenic diet is a highly effective treatment for epilepsy in some children that don’t respond to anti-epileptic drugs.
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