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.
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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: 3/31/2004
