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Do you have epilepsy? Or maybe your child does? Well, you are not alone. Epilepsy is a common disease of the brain. About 50 million people have epilepsy in the world¹, and 260,000 Canadians have epilepsy2. Adults and children can get epilepsy.
People with epilepsy have abnormal brain activity. Epilepsy is characterized by recurrent, unpredictable, and unprovoked seizures.
There is a wide range of symptoms that a person with epilepsy can experience during a seizure4. The common symptoms of seizures are:
For 50% of adults and children with epilepsy, the cause of their epilepsy is unknown3.
Some causes are known, and some are not. There are different kinds of changes in the body that cause epilepsy. These changes include:
Epilepsy is a long-term disease. Some people will have it their entire lives. There is no cure. But epilepsy can be managed.
If AEDs don’t control your seizures, then you have “intractable” epilepsy, also called refractory epilepsy. Doctors may recommend a ketogenic diet.
There are other ways to manage intractable epilepsy, like the medical ketogenic diet. It may help improve symptoms by using fats for energy instead of carbohydrates.
Anti-epileptic drugs (AEDs) treat epilepsy. AEDs can help manage or prevent seizures. However, 30% of adults on AEDs still have seizures⁵ and 25% of children on AEDs still have seizures⁶. If you still have seizures after trying at least 2 AEDs, then you have intractable or refractory epilepsy.⁶
Nutritional products are made just for the medical ketogenic diet. For example, Nutricia® makes special drinks and powders, like KetoCal®. These specialized products can be used as the sole source of nutrition or as a supplement, as recommended by a healthcare professional.
After starting the keto diet, some people may be able to reduce the doses of AEDs or even discontinue them.
The ketogenic diet is well tolerated. But it does have side effects. These include constipation, nausea, vomiting, and diarrhea. Most subside once the body gets used to the diet.
The ketogenic diet for epilepsy became popular in the 1920s. It was the preferred option for managing epilepsy. But then AEDs became available, and the use of the diet faded.
Then in 1993, the keto diet became popular again. The son of a filmmaker, Charlie Abrahams, had seizures that did not respond to AEDs. He went on the keto diet. His epilepsy symptoms improved. His parents raised awareness of the diet through books, television, and even a movie. Today, the medical ketogenic diet is still growing in popularity.
The medical ketogenic diet offers an effective way to help reduce the frequency of symptoms in most patients. And for some, it can lead to total symptom freedom.
The medical keto diet can be successful. It can help manage epilepsy symptoms when AEDs are not working. The keto diet must be strictly followed and requires careful measurements of calories, fluid, fat, protein, and carbohydrates. A clinician recommends the diet, and a dietitian will help you to get started on it.
The word “ketogenic” means that ketones are made or produced in the body.
Ketones are produced from fats eaten and are what the brain uses as fuel. Usually the brain uses glucose or sugar from carbohydrates. In a ketogenic diet, the brain uses the ketones from fat as fuel. Ketones can also be produced during fasting.
The dietitian will determine the calories, protein and fat each individual should consume. On a “classic ketogenic diet”, all foods are weighed on a scale. The “ratio” of the food will be calculated by the grams of fat to the grams of combined carbohydrate plus protein. Your specific ratio is determined by your healthcare professional based on your age, weight and energy needs.
There are many versions of the keto diet. They are not as strict as the classical ketogenic diet. All diet variants can still help people manage their epilepsy symptoms. These diets are still high in fat and low in carbohydrates. More protein is allowed in some, and how you measure the carbohydrates in them varies. Calories are not monitored as closely in each diet variant but all must be followed with your healthcare team.
Other versions of the medical ketogenic diet include:
References
KetoCal is indicated for the dietary management of refractory epilepsy and is intended for use under medical supervision. Talk to your healthcare provider to determine if KetoCal is right for you.
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