Ketogenic Diet: An Ancient Treatment in Modern Times

For most children with epilepsy, medication controls seizures very well. But for some children those medications won’t work. That’s when we turn to a treatment mimicking the only known treatment in ancient times, a Ketogenic diet.

References to using starvation to treat seizures can be found in the Bible and in references dating back to 500 B.C.  Before medications were discovered, limiting or providing excess amounts of certain substances was sometimes found to be an effective treatment for physical ailments. It was discovered that if food was withheld from someone with seizures, sometimes their seizures would slow down or stop all together. In 1911, two physicians in Paris tried starving 20 persons and found that seizures improved. However, as you might guess, this could not be used as a long term treatment.

So doctors looked for ways to produce the same effect on seizures without actual starvation. In  1921, the Ketogenic diet was discovered as a long term treatment for epilepsy. Prior to 1970, not many medications were available for the treatment of epilepsy so the ketogenic diet was used when the few medications available did not work. When there was a sudden explosion in the discovery of new medications to treat epilepsy in 1970, use of the diet decreased, but then had a resurgence after a national news report.

Today the ketogenic  diet, along with other dietary treatments such as the modified Atkins and low glycemic index diets, can be successful treatments for seizures in children with epilepsy who are not responding to medications. These dietary treatments are very strict and do not allow for any change from the specific diet plan for the child.  Children usually are required to eat large amounts of fat, just enough protein and limited fruits and vegetables. The diet may be more difficult for older children who are aware they are being deprived of foods they have liked in the past, but can be more easily administered to children who are fed by a G-tube.

Typical Foods Included:             

• Meats
• Cheese
• Select vegetables
• Limited fruit
• Heavy whipping cream
• Eggs
• Butter
• Oil

Typical Foods Excluded:

• Cereal
• Pasta, rice
• Milk
• Candy, crackers
• Peas, corn
• Bread
• Yogurt
• Potatoes

Although the diet does not have the same effects on the body of actual starvation, the diet causes changes in how the body uses foods to produce energy and is in not a “natural” way to treat seizures. Serious side effects can occur such as low blood sugar, high cholesterol, dehydration, kidney stones, and vomiting. Parents should never try to use one of these diets on their own. The Pediatric Epilepsy Center at Nationwide Children’s Hospital has a specialized team of professionals who monitor children who would like to try a dietary treatment.  Please contact the Pediatric Epilepsy Center at 614-722-4625 if you are interested in more information about one of these diets.