Posted on 05/17/2010 3:51:41 PM PDT by decimon
The high-fat ketogenic diet can dramatically reduce or completely eliminate debilitating seizures in most children with infantile spasms, whose seizures persist despite medication, according to a Johns Hopkins Children's Center study published online April 30 in the journal Epilepsia.
Infantile spasms, also called West syndrome, is a stubborn form of epilepsy that often does not get better with antiseizure drugs. Because poorly controlled infantile spasms may cause brain damage, the Hopkins team's findings suggest the diet should be started at the earliest sign that medications aren't working.
"Stopping or reducing the number of seizures can go a long way toward preserving neurological function, and the ketogenic diet should be our immediate next line of defense in children with persistent infantile spasms who don't improve with medication," says senior investigator Eric Kossoff, M.D., a pediatric neurologist and director of the ketogenic diet program at Hopkins Children's.
The ketogenic diet, made up of high-fat foods and few carbohydrates, works by triggering biochemical changes that eliminate seizure-causing short circuits in the brain's signaling system. It has been used successfully in several forms of epilepsy.
A small 2002 study by the same Hopkins team showed the diet worked well in a handful of children with infantile spasms. The new study is the largest analysis thus far showing just how effective the diet can be in children with this condition.
Of the 104 children treated by the Hopkins team, nearly 40 percent, or 38 children, became seizure-free for at least six months after being on the diet for anywhere from just a few days to 20 months. Of the 38, 30 have remained so without a relapse for at least two years.
After three months on the diet, one-third of the children had 90 percent fewer seizures, and after nine months on the diet, nearly half of the children in the study had 90 percent fewer seizures. Nearly two-thirds had half as many seizures after six months on the diet.
Nearly two-thirds of the children experienced improvement in their neurological and cognitive development, and nearly 30 percent were weaned off antiseizure medications after starting the diet.
Most of the children continued taking their medication even after starting the diet, the researchers say, because the two are not mutually exclusive and can often work in synergy.
Researchers also used the diet as first-line therapy in18 newly diagnosed infants never treated with drugs, 10 of whom became seizure free within two weeks of starting the diet. The finding suggests that, at least in some children, the diet may work well as first-line therapy, but the researchers say they need further and larger studies to help them identify patients for whom the diet is best used before medications. Hopkins Children's neurologists are actively using the ketogenic diet as first-line treatment in children with infantile spasms with promising results.
Side effects, including constipation, heartburn, diarrhea and temporary spikes in cholesterol levels, occurred in one-third of the children, with six percent of them experiencing diminished growth.
Despite these side effects, a recent study by Kossoff and his team showed that the ketogenic diet is safe long term.
Conflict of interest disclosure: Dr. Kossoff has received grant support from Nutricia Inc., for unrelated research. The terms of these arrangements are being managed by the Johns Hopkins University in accordance with its conflict-of-interest policies.
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The research was funded in part by the National Institutes of Health.
Co-investigators include Amanda Hong, Zahava Turner and Rana Hamdy, all of Hopkins.
Related on the Web:
High-Fat Ketogenic Diet to Control Seizures Is Safe Over Long Term http://www.hopkinschildrens.org/high-fat-ketogenic-diet-to-control-seizures-is-safe-over-long-term.aspx
Infantile Spasms Information (National Institute of Neurological Disorders and Stroke) http://www.ninds.nih.gov/disorders/infantilespasms/infantilespasms.htm
Daily Potassium Citrate Wards Off Kidney Stones in Seizure Patients on High-Fat Diet http://www.hopkinschildrens.org/Daily_Potassium_Citrate_Wards_Off_Kidney_Stones_in_Seizure_Patients_On_High-Fat_Diet.aspx
High Cholesterol Levels Drop Naturally in Children on High-Fat Antiseizure Diet http://www.hopkinschildrens.org/high-cholesterol-levels-drop-children-high-fat-anti-seizure-diet.aspx
Modified Atkins Diet Effectively Treats Childhood Seizures http://www.hopkinschildrens.org/Modified-Atkins-Diet-Treats-Childhood-Seizures.aspx
Carson Harris-A Patient Story http://www.hopkinschildrens.org/tpl_rlinks_nobanner.aspx?id=5972&terms=carson+harris
Journal Epilepsia http://www.epilepsia.com/
Ping
Now, if they can just put it in a pill...
Bacon and fatty beef are more fun ...
Atkins been following it for years...
Just read that coconut oil can help with seizures... This was posted on AOL.
We tried for about six months and it worked. There are lots of gluten free/casein free foods available. Its not as hard to do as you might think.
We can expect more of these epileptic spasms and reduced brain function as kids are put on politically-correct low fat diets.
Atkins. I mention that to a health professional and they bristle. But when I mention a low-starch, sugar-free diet, they smile broadly and nod their heads.
She did pitch 3 grand mal seizures in 2002 but that and the medication is/was trivial compared to what she was facing as an infant.
Jim Abrahams, one of the writers/directors of “Airplane!” started a foundation in the ‘90s to research the diet, since one of his kids had severe epilepsy.
I have a goddaughter now 14 years old who started with grand mal seizures at age 3. It’s heartbreaking to see how hard her parents looked for any solution, anything at all to help stabilize her. They became expert on foods that could possibly trigger her seizures.
She would go a few weeks without incident and her parents would express relief that maybe they found something in her diet to avoid or include. But the seizures always came back and sometimes more violently.
It’s a sad and frustrating situation to say the least.
My question is should I forward this article to the parents or is it likely they already know of this. And if this diet is known and has been around for awhile, what is unique about this article? It says only that the new study is the largest to date.
I wonder if it is only the low carbs in isolation that work. I assume the higher protein content is more important to neurological function than fats. The fats have already been shown to be beneficial to insulin tolerance.
It’s been years since I’ve read much on this diet, but IIRC it’s not just eating a lot of high-fat foods and staying away from carbs; it’s a fairly strict diet that has to be followed very carefully. It can work amazingly well but it does require commitment.
I would suggest, if they are interested, that they find someone expert in the diet and its use to guide them. It's fairly strict and carefully regulated and not just a matter of eating a lot of high-fat foods.
I think this article was referring to a particular type of seizures.
I would certainly ask them if they’ve contact Hopkins. The diet is not without its detractors. It’s very demanding — we measured everything my child ate on a gram scale — and it keeps the patient on the edge of hypoglycemia. And the import of this study is the larger numbers and the larger proportion of good results.
We followed it strictly and weighed everything she ate on a gram scale. It's mega-Atkins. You are trying to create an abnormal metabolic state and then preserve it for a long time.
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