There are many children for whom epilepsy medications like Lamictal, Depakote, and Zarotin are ineffective in controlling or even reducing seizures. These drugs, especially in combination, can also cause unpredictable and serious side-effects.
Many parents have instead turned to alternative therapies for seizure management. Because ketones seem to have an anti-convulsive effect, one of the most promising and least invasive alternative treatments for seizures has been the ketogenic diet.
Ancient Greek physicians discovered that fasting reduced seizures. At the turn of the 20th century, scientists began to study fasting as a treatment for epilepsy. Researchers found that the ketogenic effect of a 24-hour fast could be continued and maintained with a high-fat diet that included adequate protein and low carbohydrates.
During a 24-hour fast, all carbohydrate and sugar glucose that normally fuels the body is depleted. Fasting forces the body to burn stored fat as fuel for the body instead. This creates a state of ketosis. Ketones, a by-product of fat, are believed to be anti-convulsive in nature. Ketones are an effective and normal source of bodily energy produced by the liver from fatty acids.
In 1994 John Freeman, MD, published The Epilepsy Diet Treatment: An Introduction To The Ketogenic Diet. Ketogenic meals are 80% fat. This forces the body to burn dietary fat for energy and maintains the anti-convulsive state of ketosis.
With careful and proper monitoring ,, the ketogenic diet has been found to reduce seizures in two-thirds, and eliminate seizures in one-third, of all children for whom anti-epileptic drugs are ineffective. The ketogenic diet is a strict diet that can be very challenging to manage and maintain.
At Johns Hopkins Children's Center, Eric Kossoff, MD, studied the effects of a modified version of the ketogenic diet, now called the Modified Atkins Diet for Seizures His findings were published in Epilepsia in 2004. The modified diet required no initial fast and had no calorie or fluid restrictions. It allowed for unlimited protein, more carbohydrates, and didn't demand the strict portion measuring and weighing procedures practiced in the ketogenic diet.
Dr. Kossoff's research was prompted by the fact that some children remained seizure-free after discontinuing the ketogenic diet. He was also intrigued by the finding that, when the ketogenic diet was practiced less restrictively, it was still as effective at controlling seizures. One mom started her child on the Atkins diet to prepare him for the more restrictive ketogenic diet. She found that her child's seizures disappeared after three days, before the ketogenic diet had even begun.
The Modified Atkins Diet is rich in foods like butter, peanut butter, mayonnaise, oils, cheese, bacon, eggs, hamburger, and whipped cream. The diet doesn't cause children to become overweight, and overweight children often lose weight. Daily supplements are necessary to replace vitamins that are missing in the diet.
Although there are considerably fewer side effects than with drugs, the Modified Atkins Diet for Seizures can cause dehydration, constipation and, occasionally, kidney and gall stone complications. Side effects can also develop in children who are unable to digest large amounts of fat. As with all treatments, initial evaluation and careful monitoring by parents, a neurologist, and a nutritionist are all mandatory.
Researchers don't know exactly how ketones reduce and eliminate seizures, or why the diet works for some children and not others. Researchers are especially interested in why some children remain seizure-free after discontinuing the diet. Further research is needed, since the Modified Atkins Diet has only been used since 2004.
We do know that the Modified Atkins Diet for Seizures is as effective, less restrictive, and far easier than the ketogenic diet. It's an inexpensive alternative treatment option with few side effects that often works when all else has failed.