Ketogenic Diets for Epilepsy

Introduction/Summary.

This article is under construction. Caution: This a skeleton article, so only a rough outline exists. This may consist of semi-completed sections, isolated bullet point and notes to the author. You are welcome to read what exists so far, and feedback is welcomed. Email "feedback <at> fellrnr <dot> com"

Contents

1 History

• Medieval history
• Fasting in early 20^th century
• Rise of the Ketogenic Diet
• Displacement with drug therapy
• Resurgence and the Charlie foundation

2 Evolution of the Ketogenic Diet for Epilepsy

• Calorie restriction no longer used
• Fluid restriction no longer used
• New diets – MCT Diet, Modified Atkins Diet MAD
• Wider usage

3 General

• The experts suggest that if the Ketogenic Diet is going to help with childhood seizures, it will do so within 3 months.
• The Ketogenic Diet has traditionally been fine tuned to maintain urine ketone levels to 3-4+ (80-160 mmol).
• Studies have shown a correlation between >90% seizure control and lower blood glucose levels.
• The availability of blood testing for Measuring Ketones is likely to improve our knowledge, as urine testing is rather limited.
• It is unclear if the Ketogenic Diet is safe for pregnancy in the general population, but it is probably much safer than anticonvulsant drugs that have known birth defect risks
• Taking a large drink can cause some (but not all) children to experience 'breakthrough seizures'.

4 Initiation and Fasting

• Value of fasting
• Hospitalization requirements

5 Success rate for Epilepsy

• 50% of patients have a 50% reduction in seizures
• 25% have 90% reduction in seizures
• Around 10% become seizure free.
• The success rate also varies with the type of epilepsy
  • chapter 5 ("Is my child a good candidate for the Ketogenic Diet") of "Ketogenic Diets: treatments for epilepsy and other disorders" by Eric Kossoff for more details.
• In adults, weight loss is correlated with better response, though this could be due to the weight loss indicating better compliance with the diet.

6 Types of Ketogenic Diets for Epilepsy

There are several types of Ketogenic Diet used for epilepsy treatment:

• Ketogenic Ratio Diet. This diet has a strict controls over calorie intake and the ketogenic ratio, which is typically between 3:1 and 4:1. The diet is normally started with a hospital stay and includes a short fast.
• MCT Diet. This is a variant of the traditional diet that uses MCT oil that produces more ketones than other oils.
• Modified Adkins Diet (MAD). The MAD started by accident, when a child was put onto the Adkins diet prior to starting the traditional Ketogenic Diet and their seizures stopped.
• Low Glycemic Index Treatment (LGIT). The LGIT restricts the carbohydrate intake to only those foods with a Glycemic Index of less than 50. However, the LGIT is more than just restricting the glycemic index, and requires a fat intake of 60% with a ketogenic ratio of 1:1. The LGIT is similar to the MAD and restricts carbohydrates to 40-60 grams/day.

7 See Also

• The classifications and types of Low Carbohydrate Diet.
• An introduction to the Ketogenic Diet.
• My experiences with ultrarunning on the Ketogenic Diet
  • How the Ketogenic Diet can be used for the treatment and management of disease.
    • Using the Ketogenic Diets to mitigate and treat Epilepsy
    • How Ketogenic Diets might help with Cancer
    • A look at the possible mechanisms of action of the Ketogenic Diet
  • Health Risks of the Ketogenic Diet
    • Health Checks for the Ketogenic Diet
    • Supplements for the Ketogenic Diet
  • The time frame and changes that occur with Ketoadaptation
  • What are Ketones
    • How to measure Ketones
    • What ketone levels to aim for
  • The pros and cons of the Ketogenic Diet for athletes
    • The Science of Ketogenic Exercise
  • The Types of Ketogenic Diet
    • The "traditional" Ketogenic Diet based on the Ketogenic Ratio
      • The ways the Ketogenic Ratio can be calculated
        • The different definitions of Net Carbohydrates
    • Low Glycemic Index Treatment
    • MCT Diet
      • MCT
    • Modified Atkins Diet (M.A.D.)
• My Ketogenic Recipes
• Non-Ketogenic Low Carbohydrate Diets