Ketogenic Diets: Epilepsy Awareness Month

By Lauren Kronisch, MS, RD, LDN

November is National Epilepsy Awareness Month (NEAM)! One in ten people will have a seizure and one in 26 will develop epilepsy during their lifetime.

What is a seizure?

A seizure is an abnormal surge of brain electricity that may alter or interfere with regular brain cell activity. Some seizure types are not visible to anyone. Some have symptoms that appear mild to others, and some seizures look like very subtle symptoms such freezing in place, while others have much more visible symptoms. Seizures may be a symptom of epilepsy or may occur once in a lifetime. It is important to get checked out by a qualified epilepsy doctor, a specialty neurologist, to determine if one has a seizure, do they have a seizure disorder?

Epilepsy is a neurological disorder characterized by seizures that can affect any one of us regardless of race, age, or gender. Not all seizures are the same. Many people with epilepsy have more than one type of seizure. Most people with epilepsy also have triggers such as loud noises, flashing lights, or being constipated, that may cause them to have more seizures.

How is epilepsy treated?

Medications and in appropriate cases, ketogenic diet therapy. Epilepsy is treated differently depending upon the type of seizures and underlying reason for the seizures. Medications should be chosen and managed by an epileptologist. Many seizure medications have side effects such as drowsiness. Ketogenic diet therapy (KDT) may be recommended by an epileptologist as a treatment for seizures together with or instead of medications.

What is the Ketogenic Diet?

The ketogenic diet is a high-fat, low-carbohydrate diet, adequate protein diet that has at least a 50% chance of improving pediatric seizures by 50% or more. The probability of seizure improvement with KDT are better than a typical seizure medication.

There are different forms of KDT, including the classical and modified ketogenic diets, in which foods must be measured our or weighed to ensure the right proportion of fat, protein, and carbohydrates. Other forms of KDT may be more flexible (modified Atkins diet, low glycemic index diet treatment, and MCT oil diet), and only require counting and measuring carbohydrates strictly. For people who are fed through a feeding tube, there are also ketogenic diet medical nutrition products available.

Though the ketogenic diet is commonly discussed on social media and in blogs, information presented may or may not be the same as medical ketogenic diet therapy. I’ve often perused exciting new products in grocery stores, only to find they’re not keto at all (others are and

they’re great). This makes learning about KDT sometimes confusing, and important for those interested in pursuing KDT to get information from quality resources.

Since 2009, guidelines to healthcare providers for providing KDT have been maintained by a group of international expert doctors, researchers, and dietitian nutritionists. Though the ketogenic diet has existed in a form since biblical times, it became a popular treatment for seizures again in the 1990’s. Since then, much effort has gone into proving with gold standard randomized clinical trials that KDT is a safe and effective treatment option for those with epilepsy.

It is important to try KDT under the guidance of an experienced ketogenic dietitian nutritionist through a hospital’s ketogenic diet program if one is geographically close, or through a private practice if it is not and resources are available. There are potential risks to being on a KDT without proper monitoring for possible adverse effects, such as kidney stones.

To learn more about ketogenic diet therapy for yourself or your child, check out The Charlie Foundation (https://charliefoundation.org/learn-about-ketosis/). To learn more about KDT as a healthcare provider, check out The International Neurological Ketogenic Society (https://neuroketo.org/).

How else can you help someone with seizures or epilepsy?

Become trained for free in seizure first aid in English register for a free seizure first aid training) or Spanish (seizure first aid trainings in Spanish) , so that if they are experiencing a type of seizure that requires breathing assistance, you will be trained to assist.

Participate and fundraise in a Walk to END EPILEPSY®, which nationwide works to increase awareness of epilepsy, raises money to fund research and programs to support those with epilepsy.

References:

https://www.epilepsy.com/what-is-epilepsy/seizure-types https://www.epilepsy.com/volunteer/spreading-awareness/national-epilepsy-awareness-month

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983110/