The ketogenic diet first became recognized as a possible anti-convulsion therapy in the 1920s and 1930s, before being largely abandoned in favor of new pharmaceuticals which were helpful in controlling most cases. Only about 20-30% of seizure cases fail to be alleviated by medication, and thus has led to a reemergence of the diet within the past few years.The diet essentially forces the body to create ketones in the liver out of medium-chain triglycerides, which actively replace the glucose normally used as cellular fuel. The diet was discovered when Dr. Russel Wilder of the Mayo Clinic when trying to attain a diet that would mimic the effectiveness of the "fast" diets which showed significant improvement in reducing seizures in patients, but required starvation, and thus had minimal effectiveness. Studies show that the ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients. The diet is mainly only used on adolescents, but studies suggest that adults could benefit as well, depending on their ability to attain ketosis. 
Examples of the pathological physiology of seizures include: unusual excitatory connections within the neuronal network of the brain, abnormal neuron structure leading to altered current flow, decreased inhibitory neurotransmitter synthesis, malfunctioning receptors for inhibitory neurotransmitters, insufficient breakdown of excitatory neurotransmitters leading to excess, poor synapse development, and impaired function of ionic channels.[1] The exact mechanism for the ketogenic diet's effectiveness have only been speculated upon, but one theory is that the presence of glucose supports synaptic transmission, thereby hyper-activating transmission of signals throughout the brain, or half, in the case of a uni-lateral seizure. Using ketones as the primary source of energy in the brain seemingly blocks, or diverts whatever intercellular signaling pathway is instrumental in the propagation of the seizures after initiated. Whatever the mechanism, patients who have seen no success in drug therapies such as adrenocorticotropic hormone therapy, and powerful narcotic tranquilizing medications now have renewed hope in a treatment option free from many of the terrifying, and life-threatening side-effects of modern pharmaceuticals.Those affected by these tragic conditions are now given hope, and promise at the prospect of a life with fewer seizures.
Very informative dialog about the Ketogenic Diet. In reading Freeman's book on the ketogenic diet, he indicates that roughly 30% of children respond to anti-epileptic drugs while 50% do to the diet. It is so important to raise awareness about the diet. I think this is a great way to do so!
ReplyDeleteMichelle, mom to Noah (IS and intractable epilepsy)
Shane, this was a very interesting post. I have heard of the ketogenic diet before, but never as a treatment for epilepsy. This past winter while at a family health center, I observed doctors who would prescribe this diet as a means of rapid and effective weight-loss. This of course was very closely monitored, but the idea was to induce "starvation like conditions", forcing the body the tap into its own fat reserves, and as you said, attain ketosis. Very interesting that this is also an epilepsy treatment. The mechanism of seizure prevention is fascinating. Thanks for your post.
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