Nutrition

A common question asked by many people after first being diagnosed with epilepsy is "can changing my diet affect the frequency or intensity of my seizures?" Unfortunately at this time doctors still know very little about how foods can alter brain functions. We do know that low blood sugar levels can cause seizures in some people (with diabetes etc.) so it is reasonable to attempt to eat a regular and balanced diet. There is no proof, however, that mild drops in blood sugar levels can cause seizures in those with epilepsy.

Are certain vitamins or herbs beneficial?

As stated above, there is a lot of controversy over epilepsy and nutrition. Only the Ketogenic Diet has been proven effective in reducing the number of seizures in persons with epilepsy. While some have reported improvements through the use of certain vitamin supplements, isolated reports can be misleading. It is often wise not to embrace a new treatment until there is solid proof the treatment works. For instance, vitamins are certainly not harmful, and if taken in proper balance and amount can improve your overall health, but they may have little or no effect on seizures and epilepsy. Speak to your neurologist for further information.

Mineral levels & seizures

Minerals are essential nutrients used by the body. Appropriate intake levels of each mineral must be sustained for the body to function correctly. Too many minerals can lead to sickness due to the competitive nature between mineral levels in the body. For example large doses of zinc are not harmful alone but it will lead to a dangerous copper deficiency. Low levels of minerals sodium, calcium, and magnesium have been shown to change electrical activity in the brain causing an increase in seizures in those with epilepsy. Listed below are the factors often cited as causes of a deficiency in sodium, calcium or magnesium.

• Low sodium levels are often attributed to medications such as diuretics (water pills) or carbamazepine (Tegretol, Carbatrol), or by hormonal changes
• Low calcium levels often result from kidney disease or again hormonal changes. Low levels of calcium can also be caused by a deficiency of magnesium
• Low Magnesium can also be tied to low calcium levels and often indicate poor nutrition or severe alcohol abuse. Low magnesium has been shown to increase the frequency of seizures in those with epilepsy.

The Ketogenic Diet

It is estimated that up to 70% of people with epilepsy are able to control their seizures through the use of anti-epileptic drugs. For some with epilepsy, AED's are simply not enough to prevent seizures alone. The Ketogenic Diet alongside AED's may prove effective for some in reducing the number and severity of seizures a person experiences. This diet is far more effective in children than adults and should been seen as a last resort to minimize seizures resistant to AED's.

What is the Ketogenic Diet?

The Ketogenic Diet is a high fat, low carbohydrate diet designed to mimic many of the biochemical changes associated with prolonged starvation. Originally developed during the 1920's and used to treat patients with epilepsy in the 1920's and 1930's, the Ketogenic Diet was seen as the best form of treatment for people with a seizure disorder. As anti-convulsant drugs were released into the marketplace during the 1940's, the Ketogenic Diet was all but forgotten. The diet was no longer seen as a viable treatment, until the late 1990's when it was "rediscovered" to have strong seizure reducing properties. The Ketogenic Diet is now experiencing a widespread comeback in the form of treating difficult to control seizures in children.

The Ketogenic Diet should only be attempted with the consent of your neurologist and under the supervision of a registered dietician. Calories are restricted depending on age and or activity of the child. If the diet is carefully calculated the child should not gain nor lose a significant amount of weight but should continue to grow towards their ideal height and weight. For example, if the child is significantly overweight, the calories will be reduced until the child reaches their ideal body weight. The diet attempts to provide approximately 90% of the child's caloric intake as fat (butter, mayonnaise, cream etc)--one gram per kilogram of body weight.

What does the Ketogenic Diet do?

The diet is designed to simulate the many metabolic effects of starvation. While the body is in "starvation mode" it begins by using glucose and glycogen. The body then begins to burn stored up fats using the glucose. Once the glucose is no longer available, the body cannot completely burn the fats. The incompletely burned up fats leave ketone bodies which have been shown to greatly reduce seizures in some patients.

What are the side effects?

Like all treatments for epilepsy, the Ketogenic Diet may have some prohibiting side effects for some people. Side effects have been shown to cause:

• Dehydration
• Constipation
• Sometimes complications with kidney or gall stones
• Adult women may experience irregular menstrual cycles
• Adults have also been more prone to Pancreatitis (inflammation of the pancreas), decreased bone density and certain eye problems
• The diet also lacks many vitamins which must be added through supplements

How well does it work?

Doctors are not exactly sure how or why the Ketogenic Diet works but the diet has helped prevent seizures caused by epilepsy in many children who did not respond to treatment through AED's. A recent review of many studies on the diet states that over half of the children that did not respond to AED's had a 50% or greater decrease in seizures.

Some points to take note of

While the Ketogenic Diet has displayed moderate success, many doctors remain unconvinced and skeptical of its use. It is extremely difficult to plan out and follow and may pose some serious health risks as listed above. If you are still interested in pursuing this as a form of treatment, speak to your doctor or neurologist.