The ketogenic diet has been used to reduce seizures since the 1920s, and is a special high-fat, low-carb diet that helps control seizures in some people with epilepsy. It is prescribed by a doctor and carefully monitored by a dietician, and is usually used in children with seizures who do not respond to medications. The ketogenic diet is a treatment option for children or adults with epilepsy whose seizures are not controlled by AED. Diet can help reduce the number or severity of seizures and may have other positive effects. The mechanism by which seizures are controlled is not well understood, but both the low-sugar component and the high-fat component uniquely alter the “excitability” of the brain, thus reducing the tendency to generate seizures.
About half of children who follow it have a large decrease in the amount they receive, and up to 1 in 7 completely stop having seizures. The ketogenic or ketogenic diet is a low-carb, high-fat diet. When the body is forced to use fat as energy due to the lower amount of carbohydrates or sugars, ketones are produced. These ketones, which the brain can use as an alternative source of energy, have an anti-epileptic effect on the brain. This can lead to better control of seizures. The original ketogenic diet was developed by Dr.
Russell Wilder of the Mayo Clinic in 1923, as a treatment for epilepsy. Normally, the body depends on glucose (blood sugar), a by-product of carbohydrate conversion, for energy. If you can't find carbohydrates to convert, the body will believe you are fasting and will start converting fat into energy; instead of producing glucose, the body will produce ketone bodies. Once there are elevated levels of ketones in the bloodstream, the body enters a state of ketosis, which has been shown to improve neurological conditions and metabolic disorders, including epilepsy. There are five versions of the ketogenic diet used to treat epilepsy.
The original, now known as the classic ketogenic diet, was created in 1923, followed by more recent types known as modified ketogenic diet, medium chain triglyceride (MCT) diet, modified Atkins diet, and low glycemic index (LGIT) treatment. The various types of ketogenic diets have been used for years and have been studied in people with epilepsy who have failed to control seizures with anti-seizure medications. Johns Hopkins is a long-standing pioneer in this mode of therapy. Unlike the strict fat to carbohydrate and protein ratio of the classic diet, the MCT diet is calculated by the percentage of energy (calories) that these particular types of fats provide. If the side effects are too much for your child, ask your doctor about other diets for epilepsy such as the modified Atkins diet and the low-glycemic treatment diet. Observations that the ketogenic diet can modulate and transform the intestinal microflora create a potential and promising basis for future dietary therapy.
Diet follow-up time may vary but if a person remains seizure-free, has fewer seizures or maintains other benefits such as a better quality of life they may consider (with their medical team) stopping the diet slowly after two years. The effectiveness of the ketogenic diet remained stable for 3 to 6 months and the diet was not interrupted due to tolerance. Mackenzie Cervenka, neurologist and director of Johns Hopkins Hospital Adult Epilepsy Diet Center explains what the ketogenic diet is and how it can benefit people with epilepsy. So, what drug is used against now to treat epilepsy should we try the ketogenic diet? There is no doubt that due to extensive data from preclinical studies as well as early results from individual patients or small cohorts, the next task should be to test the ketogenic diet in well-designed and controlled clinical trials. Parabacteroides merdae, Sutterella and Erysipelotrichaceae also increased significantly while Allobaculum, Bifidobacterium and Desulfovibrio were lower in mice fed the ketogenic diet compared to mice fed the control diet. Atkins developed a weight-loss diet that restricted carbohydrate intake (Sharma and Jain 201) and this diet was later evaluated for treatment of seizures. The types of food eaten and how each diet is calculated are slightly different but each diet has been shown to be effective in randomized controlled trials in reducing seizures in some people.
Wilder a doctor at Mayo Clinic in Minnesota suggested that a specific diet could produce similar benefits to fasting and proposed a diet that would produce ketonemia. Therefore a ketogenic diet triggered an increase in ketone bodies and blood fatty acids can also regulate neuronal membrane excitability by activating two-pore domain potassium channels and this can be taken as another likely anticonvulsant mechanism of the ketogenic diet.