What is your opinion on the effectiveness of the ketogenic diet for epilepsy?
Preliminary results from a multicenter study seem to indicate that it can be useful in controlling seizures of a percentage of children who had not been controlled with anticonvulsant medications. Approximately 33% of these children gain full control, and another 33% are able to get improved control and decrease their medications. Seizure type does not predict which child may benefit from the diet.
The other benefits of the ketogenic diet are mainly avoiding the side effects of anticonvulsants such as sedation or impaired thinking, as well as the cost savings. The downside to the diet is that it is very difficult to follow. The diet stipulates that for every 6 calories consumed, four must be from fats and the other two from both proteins and carbohydrates. It is very difficult for children to avoid carbohydrates. The serving portions must be carefully weighed and the diet must be overseen by a dietician trained in the diet. Further, the diet must be started with a 24 to 48-hour fast that is monitored while the child is hospitalized to prevent hypoglycemia.
Like anticonvulsants, the diet is not a cure, but merely another treatment mode for hard to control seizures.
This answer was written by Len Leshin, MD, FAAP, a pediatrician in Corpus Christi, Texas, who hosts an excellent Web site dealing with Down syndrome and various other pediatric topics. Additional information is available on the Stanford University Department of Medicine’s Web site.