Epilepsy & Seizure information

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Epilepsy information

http://www.second-opinions.co.uk/epilepsy.html

 

Dietary causes:

Carbohydrate-rich diet; cereals.

 

Epilepsy today is generally controlled with antiepileptic medications.

Occasionally surgery and nutritional strategies are also used. Despite these, up

to

30% of epilepsy seizures are not adequately controlled. Yet for decades a

carefully calculated ketogenic diet, very high in fat, low in protein, and

almost

carbohydrate free, has proven to be very effective in the treatment of

difficult-to-control seizures in children. This ketogenic diet for epilepsy was

only

discontinued for the control of seizures as new medications were developed.

Nevertheless, Johns Hopkins Medical Center in the USA has continued to use it in

epilepsy with great success.[1]

 

 

The Johns Hopkins Ketogenic Diet for epilepsy was first formulated in the

early 1920's It is a carefully calculated diet, in which some 90% of calories

come from fat. The other 10% is almost all from protein as it is almost

carbohydrate-free. It is very effective when used for the treatment of

difficult-to-control seizures in children. For more than three-quarters of a

century, it has

been very effective. However, many centers stopped using the diet to control

seizures as new medications were developed.

 

Of recent times a ketogenic diet very high in fats has been advocated for

epilepsy again in other centres. Again about 90% of the calories in the diet

come

from fats. It is not clear what mechanism of action accounts for reports of

decreased epileptic seizure activity during ketosis. Drs. Lefevre and Aronson

of Northwestern University Medical School, Chicago, reviewed the literature to

determine if there was any evidence that a ketogenic diet could be useful in

paediatric patients with intractable epilepsy.[2] They analysed eleven

published studies and one unpublished study. The results of this review are

shown

below:

 

The range of patients

who:                                      \

           

 

Became completely seizure free               7 – 33%

 

Had more than 90% reduction              22 – 56%

 

Had more than 50% reduction              29 – 100%

 

Although there were some adverse effects such as gastrointestinal symptoms in

up to half of the epileptic children, these only lasted for a short time and

were probably caused because the diet was so different from what the children

were used to.

 

These studies of the ketogenic diet in epilepsy were not placebo-controlled

and the evidence gleaned was not of the highest quality. Nevertheless, it is

not likely that the results were merely caused by the placebo effect or by the

spontaneous remission that sometimes occurs in childhood epilepsy.

 

It's not just for children

 

A small study of eleven epileptic adults: nine women and two men, conducted

at Jefferson Medical College, Philadelphia, and published the previous year had

showed that this diet works for adult epileptics as well.[3] After eight

months of follow-up, three patients had a 90% decrease in epilepsy seizures,

three

patients had between 50% and 89% decrease in seizure frequency, and one

patient had less than 50% seizure decrease. The other four patients discontinued

the diet. The authors say 'The ketogenic diet shows promise in both adult

generalized and partial epilepsy' but recommend further study.

 

But what will further study achieve? This ketogenic diet regime has been used

successfully in epilepsy for over 80 years and it conforms almost exactly to

the diet advocated here for the prevention and alleviation of many other

conditions. With millennia of epidemiological evidence and a wealth of clinical

study to back it, I see no reason to suppose it has any inherent dangers.

 

Johns Hopkins scientists have produced a text and a computer disc which

enables families to calculate the diet more easily. (see

http://www.neuro.jhmi.edu/epilepsy/keto.html)

 

Epilepsy and schizophrenia

 

Several studies, have found that patients with epilepsy tend to have a higher

prevalence of schizophrenia-like psychosis compared with the general

population. The authors of a population-based Danish study of 2.27 million

people

report that 'There is a strong association between epilepsy and schizophrenia or

schizophrenia-like psychosis. The two conditionsmay share common genetic or

environmental causes.'[4] It may be significant that this study showed that the

type of epilepsy didn't seem to affect the likelihood of schizophrenia. The

risk increased with increasing number of admissions to hospital for epilepsy

treatment and particularly with increasing age at the first admission for

epilepsy. As most hospitals treat epilepsy with drugs and a 'healthy' diet,

could they

be the reason for the increased risk?

 

 

References

 

[1].  http://www.neuro.jhmi.edu/epilepsy/keto.html . Accessed February 2002

[2].  Lefevre F, Aronson N. Ketogenic diet for the treatment of refractory

epilepsy in children: a systematic review of efficacy. Pediatrics 2000; 105:

e46.

[3]. Sirven J, Whedon B, Caplan D, et al. The ketogenic diet for intractable

epilepsy in adults: preliminary results. Epilepsia 1999; 40: 1721-6.

[4]. Qin P, et al. Risk for schizophrenia and schizophrenia-like psychosis

among patients with epilepsy: population based cohort study. BMJ 2005;331:23.