- Diseases, Disorders & Conditions
The ketogenic diet: Cure for epilepsy at last?
Epilepsy has plagued humans for generations. The condition is caused by a variety of events including stroke, head trauma and infection. Basically, epilepsy is characterized by unprovoked seizures. During seizures, electric communication between neurons is disrupted. This results in an altered state of consciousness or abnormal movements. Though it is a very common condition, the real cause of epilepsy has never been identified.
Currently, epilepsy affects more than 2.3 million adults and close to 500,000 children in the U.S. In addition, about 1 out of 26 people will be diagnosed with the condition at some point in their lives.
Just as the real cause of epilepsy is unknown, there is no conclusive treatment for the condition. In ordinary circumstances, treatment involves using pharmaceutical interventions or surgery. Physicians use anti-epileptic drugs such as acetazolamide and benzodiapines which work on the central nervous system. These reduce seizures but cannot cure the condition.
While medications reduce and manage seizures, they also come with many side effects including kidney stones, liver injury, respiratory problems and dependence. The drugs are also known to cause depression and bring the onset of suicidal thoughts. In addition, there are many epileptics who do not respond to these medications while surgery carries many risks. The good news is that there is an extremely effective dietary approach that has been proven to be highly effective in treating the condition.
The keto diet
While there are many fad diets out there, this is the only diet that truly lives up to its name. It does not involve eating certain superfoods that the body needs to stay in tip-top condition or abstaining from others. In fact, scientists and researchers are still baffled at how the diet works but what they know is that it works effectively for lots of people who have battled epilepsy for years.
The ketogenic diet, also known as keto diet is a high fat, low-carb with controlled protein diet aimed at putting the body in ketosis or fasting mode. The name ketogenic means that it produces ketones in the body. Ketones are produced when the body uses fat as its primary source of energy unlike in ordinary circumstances where carbs are used as fuel.
Fasting has been used as treatment for various diseases for thousands of years and was studied keenly by ancient Indian and Greek physicians. According to an ancient treatise in the Hippocratic Corpus on “On the Sacred Disease,” diet alterations play a critical role in the management of epilepsy. The same collection describes how a man recovered from epilepsy when he abstained from eating and drinking.
Since fasting cannot be sustained in the long term, the keto diet comes in handy to mimic the effects of fasting. Normally, people who are put on the keto diet begins by fasting for about 24 hours before they start on the diet. Here, fasting is used to fast-track the onset of ketosis.
Treatment for epilepsy
In 1994, the keto diet shot to fame when it worked for a toddler, Charlie Abraham who had experienced severe seizures since birth. No treatment seemed to work for him, until he was put on the ketogenic diet and his condition improved significantly. The frequency of the seizures were reduced and he exhibited improved cognitive development which doctors had almost ruled out. His father was confounded and wondered why no one had ever mentioned the diet.
Abraham’s father discovered that after the initial tests on the keto diet and its ability to treat epilepsy in the 1920s and 30s, new antiepileptic drugs emerged. Physicians found it easier to administer pills rather than guide patients on how to use the diet. The “pill-for-everything era” ensured that the diet was forgotten for years until the Charlie Abraham incident.
The first reputable scientific study linking fasting to the cure of epilepsy was conducted in France in 1911.During this period, epileptics were being treated using potassium bromide. However, this treatment was shown to have negative effects on the patients since it slowed down their mental capabilities. When patients were put on strict dietary restrictions, it was found that their mental capabilities improved compared to when they were on potassium bromide. In addition, the patients experienced fewer seizures.
In 1922, Hugh Coklin, an American homeopath showed that when an epileptic person fasted for 18 to 25 days, the patient experienced a significant reduction in seizures. When Coklin put patients on water diet which he used regularly to treat most of the children suffering from the condition, 20 percent of the patients were cured of the condition while 50 percent showed significant improvements.
During a recent clinical trial at Great Ormond Street Hospital in 2008, researchers noticed that the diet reduced seizures in children who did not respond to medications. After 3 months on the diet, 40 percent of the children experienced 50 percent reduction in seizures. They were also able to reduce their medication significantly.
In spite of its many benefits, there are people who experience negative effects when they are put on the diet. However, most of these effects are mild and usually resolve when the body gets used to using fat rather than carbohydrates as fuel.
Side effects include:
Feeling sluggish for a couple of days after starting the diet
Slowed weight or growth
Ultimately, though the keto diet has been shown to be highly effective in treating epilepsy, no scientific explanation exists to demystify its therapeutic mechanism for the condition. Researchers attribute the reduction of seizures to the presence of ketones in the blood, but that is still inconclusive. As a result, more studies need to be conducted to find out how and why the keto diet work effectively for epileptics who do not respond to conventional interventions.
While the jury is still out on how the diet works, what doctors and patients know is that the diet holds a lot of promise for people with drug-resistant epilepsy. In the words of Sanjay Sisodiya, Professor of Neurology at University College London and Epilepsy Society “It is encouraging to see that the keto diet might hold the potential for treating and reducing seizures in some adults as well as children”.