|
What is a ketogenic diet?
The ketogenic diet is one of the oldest
treatments for epilepsy. It has long been recognized that seizures often lessen
or disappear during periods of fasting in some individuals with epilepsy. A ketogenic diet is intended to maintain
a starvation or fasting metabolism
for a sustained period of time. The exact mechanism of the diet is not known,
but seems to depend on the body being in a state to create ketones, which are
by-products of fat-burning metabolism that occurs with fasting.
The diet is very high in fat and low in carbohydrates (sugars). When fat is
the primary source of calories, ketones are formed, which can be measured in
blood and urine. To maintain the correct balance of ketones, the diet must be
followed very closely. The diet often works best when the amount of fluid intake is also
restricted. Children on the diet often will not gain weight or grow much during
the months or years the diet is in use.
In what type of seizure patient is a ketogenic diet tried?
The diet has been used mostly in children with difficult-to-control,
generalized epilepsies--such as those with the Lennox-Gastaut syndrome (a form
of severe epilepsy that mainly affects developmentally and mentally delayed
children with seizures that include generalized but brief body
jerks, drop attacks, and grand mal seizures). In this group of individuals, the
diet can be as successful as medications. Thus, the diet is most often
recommended for children ages 2 through 10 or 12 years old who have been
diagnosed with a generalized type of epilepsy, and in whom medications have failed. In addition, caregivers and the individual need to be
able to strictly monitor every bite of food and sip of water the individual
takes.
How long is the ketogenic diet maintained?
The diet is typically started with a period of fasting lasting up to a few
days, until the body produces a moderate to large amount of ketones. The diet
then proceeds in a step-wise fashion over several meals. This initiation period
usually takes place in the hospital, so that the individual can be monitored for
potential side effects such as vomiting, low blood sugar, dehydration and
seizures. Medications may also be adjusted during this period to prevent
sedation, a common side effect.
A 2-month trial period is suggested for deciding whether the diet is
effective. If effective, it is typically continued for 2 years. During this
time, individuals are often able to reduce the amount of medication they take
for seizures. Many children seem happier and more alert on the diet, even before
medication is significantly reduced.
|
