Ketogenic diet for epilepsy
The ketogenic diet. With the development of effective anticonvulsant drugs, the dietary treatment was dropped. But now neurologists at Johns Hopkins Hospital have refined a dietary treatment for severe epilepsy. After about 24 hours of fasting, the body depletes its reserves of glucose and starts to burn stored fat for energy. However, burning fat in the absence of glucose gives off waste products called ketone bodies, which build up in the blood and are excreted in the urine. Very high blood levels of ketones can upset body chemistry, and even lead to a coma and death, But at lower levels they can eliminate seizures. Carefully structuring the diet by allowing only a sprinkling of carbohydrates can result in a therapeutic level of ketones in the bloodstream. This regimen, called the ketogenic diet, appears to work best in young children, especially that 20 percent whose seizures are not adequately controlled by drugs. The diet provides about 75 percent of the calories generally recommended for healthy children, and most of these come from fats. A small amount of protein is added to allow for at least some growth, but carbohydrates are kept to a minimum. Fluid intake is restricted. The diet must be carefully tailored and then followed exactly; a small deviation can bring on seizures. To begin, the child is hospitalized for 2 or 3 days of fasting, after which the ketogenic diet is gradually introduced. The diet can be difficult to follow, but afrer 2 to 3 years, most patients can resume a normal diet and still be seizure-free.
