For nearly a century, the low-carb, or ketogenic, diet has been used by physicians to treat atypical absence seizures, an epileptic syndrome. As anticonvulsant medications were developed to help control atypical absence and other epileptic episodes, the low-carb diet fell into disfavor. However, during the 1990s, the ketogenic diet reemerged as an alternative method to control seizures.
Atypical Absence Seizures
Atypical absence seizures occur mostly in children up to 6 years old. In many cases, these atypical absence seizures occur in children who have difficulties achieving developmental milestones and integrating skills, and have a hard time with memory, concentration and the senses, so an atypical seizure may often be overlooked. Signs that your child is having an atypical seizure may include a gradual unresponsiveness or blank staring for several seconds, rapid eye blinking, and slight lip twitching, all without a discernible rise in the rate of respiration. In many cases, your child won't respond to first line antiepileptic drugs and a change in diet will be needed to control the seizures.
Ketogenic Diet
The ketogenic diet was developed when it became obvious to physicians that fasting reduces seizures. Ketosis and acidosis, which are a result of the high-fat and low-carbohydrate nature of this diet, have been known to have antiseizure effects. The high fat content of the diet mimics fasting while providing nutrients to the child, and the low-carb aspects of the diet eliminate sugars, starches and other forms of carbohydrates so that the body doesn't have to deal with them. You need to consider the diet if your child’s atypical absence seizures don't respond to the antiepileptic drugs, or if harmful side-effects as a result of the seizures have occurred, such as general cognitive disorders and increased convulsions.
Beginning the Ketogenic Diet
The ketogenic diet is so stringent that the initial fasting periods must be started in the hospital under strict care to ensure that severe metabolic disorders, such as hypoglycemia, don't occur. Your child will be fasting for several days until ketosis is achieved and then the diet will be administered until he reaches a balanced ratio of fats, carbohydrates and proteins. In addition, you will also be receiving training by your hospital to administer and monitor the diet at home.
A Typical Ketogenic Menu
Ketogenic diets are actually quite easy to follow and provide for many tastes and variations. The focus is to create nutritious meals totaling approximately 1,500 calories per day, with extra fat content and moderate protein, such as eggs, heavy cream, dairy products, peanut butter, beef, seafood, fruits and fresh vegetables, and rich but simple desserts, such as pudding, custard and yogurt.
When to Stop the Diet
While there are some adverse effects, such as renal stones, mineral and vitamin deficiencies, dehydration, a weakened immune system and a decrease in bone growth, these may be avoided if you closely monitor your child’s diet and regimen. Each child’s needs differ, so your child's diet ratios may change over time as they grow older. For instance, if a child is at infant stage, a 3 to 1 ratio of fats to protein and carbohydrates may be administered, where as after year 3, this may change to 4 to 1. After a couple of years on the diet, if your child no longer has seizures, you and the doctors may reevaluate and modify the diet, or even stop it altogether.
References
- Epilepsy.com Professionals: Absence
- Mayo Clinic Procedings; Therapeutics in Pediatric Epilepsy, Part 1: The New Antiepileptic Drugs and the Ketogenic Diet; Randa G. Jarrar, Jeffrey R. Buchhalter
- Washington University of Medicine, Department of Neurology: Ketogenic Diet
- American Epilepsy Society: Clinical Epilepsy
- Diet.com: Ketogenic Diets
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