The ketogenic diet is used as a method for treating seizures and has been recommended for certain mitochondrial/metabolic disorders. The ketogenic diet is used when a child's seizures have not been satisfactorily controlled with adequate trials of medications or when a child has experienced undesirable effects from the various seizure drugs. An important requirement for beginning the diet is a commitment from those who will be taking care of the child, as the diet requires extra time and effort.
The word "ketogenic" refers to ketone bodies that are products of fat breakdown. The ketogenic diet is specifically planned to meet all of your child's caloric requirements for growth and development, but it does contain excess fat and it contains only limited carbohydrate and protein. The diet works by changing how the brain obtains its energy to function. Instead of getting energy from sugar, the brain will get energy from fat. Precisely how this helps to control seizures is not known.
The ketogenic diet is not new. It has been effectively used for many years and has decreased the frequency of seizures in thousands of patients. Prior to beginning the diet, we will request that you become as familiar as possible with the rationale for using the diet. It is essential that you learn what will be required in planning and preparing the diet. In addition, you should be aware of the possible side effects of the diet.
You will be meeting with the ketogenic diet team during the hospital admission and frequently while your child is on the diet. The team consists of a neurologist, a registered nurse (ketogenic diet coordinator), and a registered dietitian. Meal plans will be provided before you leave the hospital. Should problems arise while you are at home, the ketogenic diet team will be available to answer your questions.
Once your child is admitted to the hospital, he/she will initially receive only limited amounts of water or sugar-free liquids until he/she begins to show ketone bodies in the urine. Do not allow your child to eat or drink anything else. Usually within 24 hours of admission to the hospital your child will begin the ketogenic diet. The diet contains a fixed amount of calories, carbohydrate, fat, and protein. Your child will also need extra calcium, vitamin D, iron and other vitamins, and these will be provided in your diet plan. Most children accept the diet unexpectedly well. On occasion your child may become sleepy, may vomit, or may refuse the first few meals. These are usually only short-term problems.
Initial responsiveness to the diet may be seen within the first 48 hours but often the effectiveness of the diet cannot be judged for one to three months.
In the beginning of the diet, your child's seizure medicines will be continued. Often, these can later be reduced or discontinued under doctor supervision. It is possible that your child may require some drug treatment for optimal seizure control. The ketogenic diet is effective only when your child is ketotic and even the smallest amount of sugar will "break" the diet and seizures may return.
Before leaving the hospital you will be shown how to check for ketone bodies in the urine. This must be done at least twice a day for the first few months. If your child becomes seizure free you will only be required to test urine ketone levels if seizures return.
If your child is helped by the diet and seizures are more controlled, your child may remain on the diet for two to three years, or longer. The length of time on the diet will be determined by multiple factors including the extent to which the diet benefits your child, the effective weaning your child off of seizure medications, and your willingness to prepare and continue the diet.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 7/15/2009...#7156
