Seizures and Epilepsy in Children by unknow

Author:unknow
Language: eng
Format: epub
Publisher: Johns Hopkins University Press
Published: 2023-01-15T00:00:00+00:00

CHAPTER 12 Ketogenic Diet Therapy

Ketogenic diet therapy has been a scientifically proven, nonpharmacologic treatment for epilepsy since 1921, more than one hundred years ago. It was first created at the Mayo Clinic in Rochester, Minnesota, as a sustainable way to mimic fasting and starvation diets, which had been used for several decades by faith healers. Although we know now that fasting and the ketogenic diet are completely separate treatments (and both work), these two treatments have been linked ever since.

For the next 20 years, the classic ketogenic diet was popular, as there were few other antiseizure medications available, and research flourished at the Mayo Clinic, Harvard, and Johns Hopkins. In the 1940s and especially 1950s, articles about the ketogenic diet dwindled, possibly as the new generation of neurologists didn’t believe people would follow such a rigid diet and researchers interested in the diet moved on to other fields. In the 1960s and 1970s, new antiseizure drugs emerged on the scene, and the ketogenic diet was perceived as unnecessary, antiquated, and to be used only as a last resort in children with refractory epilepsy. Things changed dramatically in 1994 with the creation of the Charlie Foundation, which was named after a young boy named Charlie Abrahams who became seizure-free after starting the ketogenic diet here at Johns Hopkins under the guidance of Dr. John Freeman and his dietitian, Millicent Kelly. The ketogenic diet has since been studied and used further and is one of the mainstream treatments alongside drugs, surgery, and neurostimulation today.

We are now in a renaissance of sorts for dietary therapy as we approach its second century. Five different forms of diets can be used to treat seizures. The ways in which we start the diet, long based in tradition, have been challenged in meaningful and creative studies. Side effects have been well described and are often prevented by various supplements. New indications, including for conditions outside childhood epilepsy, have emerged on the scene. Biannual conferences with 500-plus attendees have been held all over the world for ketogenic diet practitioners; several published guidelines and consensus statements exist to guide expert management; and a new society, INKS (International Neurological Ketogenic Society), has been created (www.neuroketo.org).

This chapter provides some basic information about diet therapy for interested parents and children. In addition, the Johns Hopkins ketogenic diet team has recently published the updated seventh edition of their book Ketogenic Diet Therapies for Epilepsy and Other Conditions. We encourage you to read this book if after this chapter you want to learn more information. There is also additional ketogenic diet news at Keto News (www.epilepsy.com/ketonews), a blog on the latest science and happenings. When used for epilepsy, especially in children, however, we do not recommend starting the ketogenic diet on your own without medical guidance.

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