The Ketogenic Diet in the Treatment of Epilepsy

Abstract

on Pediatrics is presented for the purpose of comparing the results of various forms of treatment, and to present a new dietary regimen, the ketogenic diet.Forty-six of the patients were males, and forty were females. The youngest patient was 1 year of age, the oldest 15 (the arbitrary age limit for patients in the Section on Pediatrics). The average age of the patients was eight and fifty-one hundredths years. The average duration of symptoms, as noted by the parents, was three and three-tenths years.Thirty patients had had previous treatment; in twenty-three of these the results of the treatment were fair, that is, there was a decrease in the number and in the severity of the attacks. The condition of twenty\x=req-\ two of the patients was diagnosed petit mal; of forty-one, grand mal, and of twenty-three, grand and petit mal. Forty-three patients had a history of hereditary taint or familial disease. Twenty had a definite family history of sick headache (migraine), nine of epilepsy, and fourteen of insanity, nervousness and so forth. In nineteen cases there was a history of difficult labor, and in twelve of these, delivery had been by instru¬ ment. Eight patients had had infantile convulsions ; four, severe injury, and ten especially severe acute infections. In sixty-eight cases, the dis¬ ease had been definitely progressive, the attacks increasing in number and severity ; in two, the number and severity of attacks had decreased, and in sixteen the disease was considered stationary. The only important point in the physical examination of these patients was the demonstration of foci of infection, such as dental caries, infected tonsils and adenoids, and in two patients, of defects in the skull. Thirty-eight patients had definite foci of infection. The Wasser¬ mann blood test was negative in all of the eighty-six patients. The roentgen-ray examination of the skull was negative in seventy-eight patients. In three there were areas of bone defect, old fractures ; and in three there was reported evidence of slight increase in intracranial pressure, but the patients had no other signs of increased intracranial pressure. The fundus was essentially normal in the entire series.

Ketogenic Diet Metabolites Reduce Firing in Central Neurons by Opening KATPChannels

“…One very effective alternative is dietary treatment. The ketogenic diet, introduced in the 1920s (Wilder, 1921;Peterman, 1924;Freeman et al, 2000;Bailey et al, 2005), is a low-carbohydrate, high-fat regimen on which ϳ30% of patients become seizure free, and ϳ60% experience significant benefit (Thiele, 2003). This effectiveness is seen across different seizure types and seizure etiology, suggesting that rather than targeting specific causes of seizure [aside from certain metabolic disorders (Wang et al, 2005)], the diet enhances the activity of an endogenous antiseizure mechanism.…”

Effect of the Ketogenic Diet on the Activity Level of Wistar Rats

“…Attention (6,11), cognition (12,13), and behavior (6,11,12) have been reported to improve in individuals who have epilepsy and are on the ketogenic diet. The improvement in these domains seems to be unrelated to the level of seizure control attained (6).The ketogenic diet is a high-fat, low-carbohydrate, and low-protein diet (14,15). It is an effective treatment for intractable epilepsy (5,11,12) and has been found to be useful in controlling seizures that have proved to be unresponsive to drug treatment in both children and adults (15,16).…”

Epilepsy and the Ketogenic Diet: Assessment of Ketosis in Children Using Breath Acetone

“…Geylin demonstrated that prolonged fasting could be used to treat intractable epilepsy (1). This led to Wilder's development, in 1921, of a high-fat KD for the treatment of intractable seizures (1).…”

“…This led to Wilder's development, in 1921, of a high-fat KD for the treatment of intractable seizures (1). The high-fat KD was intended to mimic the physiologic effects of fasting, while avoiding the obvious limitations of prolonged food deprivation (1).…”

“…This led to Wilder's development, in 1921, of a high-fat KD for the treatment of intractable seizures (1). The high-fat KD was intended to mimic the physiologic effects of fasting, while avoiding the obvious limitations of prolonged food deprivation (1). Used successfully for approximately 80 years, the KD continues to be one of the most important therapies for intractable childhood seizures (2).…”