Research Shows the Ketogenic Diet Reduces Seizures in Focal Epilepsy

In my last posting I reviewed some of the recent progress in research on the use of the ketogenic diet.  In this posting I’d like to follow up by reviewing an exciting study published this past February by a group of French researchers on the use of the ketogenic diet for patients with focal epilepsy (also called partial epilepsy).

The study, published in the journal Developmental Medicine and Child Neurology, was conducted by a group of French medical researchers led by Dr. Nathalie Villeneuve.  Over a period of three years, they studied patients between the ages of 5 months and 18 years old who had focal epilepsy and whose epilepsy was not suitably controlled with medication.  Their goal was to determine whether a particular population—children with focal epilepsy that had recently increased in frequency—was a group that would benefit from the use of the ketogenic diet.

Ketogenic Diet Helps Many Kids; Some Become Seizure-Free
All children studied had serious, highly drug-resistant epilepsy; all but one had daily seizures.  They were a mix of male and female children and were gradually introduced to the ketogenic diet while hospitalized. Their parents received education on the diet during the five days at the clinic.  The children were evaluated a month after beginning the diet; those who had improved were continued on the diet for varying lengths of time, depending on the patient’s needs.

After a month, half of the patients had significant improvement.  About half had experienced at least a 50% reduction in frequency of seizures, while roughly 30% were seizure-free.  Eighty percent of those who had reduced seizures experienced this improvement in a week or less.  Some patients discontinued the diet, either because they did not tolerate it well or because it was not decreasing their rate of seizure. 

The age at which children had first experienced seizures had no correlation with whether or not they experienced improvement while using the ketogenic diet as a therapy.  Having had a recent increase in the frequency of seizures, however, did make it more likely that the ketogenic diet would help the patient improve. 

Side effects occurred for a small number of patients, including vomiting, hypoglycaemia, and drowsiness.  Monitoring is important for patients who undertake the diet.

Why Is the Ketogenic Diet Especially Helpful for Recently Worsened Epilepsy?
It might seem counterintuitive that when a condition has recently gotten worse, it would respond better to a treatment.  But when you consider how the ketogenic diet works, it actually makes sense.

Seizures increase the consumption of glucose in the brain.  The way the ketogenic diet works is, by reducing carbohydrates and increasing fats, forcing the brain to use ketone bodies for fuel instead of glucose.  Because the brain can’t make its own reserves of ketones, the increase of energy needs related to seizures remains unmet if the brain is consuming ketones instead of glucose.  For patients whose seizure frequency has recently increased, the consumption of glucose has also been accelerated, so the switch to ketones is more effective in reducing seizures in these patients.

Implications for Treating Children
Villeneuve and her colleagues conclude that, at least preliminarily, their research suggests that children who have focal epilepsy that does not respond to drugs should be treated with the ketogenic diet.  In emergency situations, if a patient is not responding to drugs, they suggest that intravenous fluids should be glucose free, and the ketogenic diet can either be introduced gradually (to reduce side effects) or with fasting to increase the speed with which the diet becomes effective.

The researchers have also used the ketogenic diet with children suffering from status epilepticus (a condition of nearly continuous seizure), and found it to be effective in nearly half the cases.

The big news here is timing:  When patients have recently had an increase in seizures,  that seems to be the right time to start the ketogenic diet.

About the Contributor: 
Matthew Papaconstantinou, PhD,  works as a postdoctoral research fellow for the department of Biochemistry and Molecular Biophysics at Washington University Medical School in St. Louis, Missouri (MO).  He has received two research grants from the American Heart Association to support his research on cardiovascular diseases (CVD). 

Matt is particularly interested in the field of obesity treatment and spends his leisure time developing an online nutritional calorie counter tool that can help people manage their weight, and offers helpful information for people who are looking for weight loss programs reviewed and coupons for Medifast diet.