6 Reasons to Use a Diet in the Treatment of Seizures and Epilepsy

Epilepsy and seizure disorders are conditions that are very debilitating and can damage the quality of life. While drugs are always used as a first-line approach, diets can play an active role.

At the center of epilepsy is a problem with the way our brain cells produce energy. For those of you who stay awake in high school biology, this refers to mitochondria. “Cell power plant” that produces ATP. I have heard it say that our bodies have more than one billion (yes – with “b”) reactions that occur every second of every day. Each of these reactions requires energy in the form of ATP. That's a lot of ATP.

At rest, our nervous system is the use of the highest energy in our body. It takes a large amount of energy for our brain and nerves to function correctly. Often this involves NOT doing something. If that sounds strange, consider stroke patients or Parkinson's patients. They have lost or damaged some of their brains and, as a result, the muscles in the body can contract and not relax, causing seizures to occur.

So, in epilepsy, something happens to reduce the energy produced by brain cells. This can be stress, malnutrition, toxic chemicals, heavy metals, lack of exercise or many other factors combined with susceptible genetic makeup (however, this does not indicate that seizures are dependent on genetics – not even close to reality). When the cell does not have enough energy, the cell lights up before it should, creating the beginning of a seizure.

Medications used to control seizures do not affect their shape at all. They only prevent one cell from communicating with the cell next to it. In this way, the cell that burns when it doesn't should affect its neighbors less. But brain cells remain sick. So, while drugs may be necessary for short-term seizure control, the use of anti-seizure drugs (AEDs) without recommendations for lifestyle changes to impact actual problems with brain cells do more damage than good for the patient.

One very powerful approach is the ketogenic diet. This is a diet with a high percentage of protein and fat (similar to the Atkin diet), although research continues to observe how effective the diet is. One example is the modified ketogenic diet.

How effective is the ketogenic diet? In reading this, keep in mind that the choice of the first drug for the reduction in seizures is effective about 30% of the time.

* 1/3 of those on the ketogenic diet have reduced seizures> 90%
* 1/3 others have a reduction of> 50%

In a long-term follow-up study of the ketogenic diet in children over 20 years it was found that there were clear long-term benefits for reducing seizures only from the diet:

1) 65% of patients continue to go on a diet (this level of adherence to AED almost never happens)
2) 20% become seizure free
3) 36% experience a decrease in seizures 75-99%
4) Overall, 56% of patients experienced a reduction in seizures of more than 75%
5) Of those who are free of seizures and stopping their diet, seizures only occur at 25%
6) Of patients with reduced seizures> 50% who discontinued their diet, only 25% experienced recurrent seizures.

Because there is an evident ability to stop the ketogenic diet, this particular study (http://www.sciencedirect.com/science/article/pii/S092012111100091X) looks at whether stopping the ketogenic diet in one week vs. six weeks produces a difference and finds that there is no increased risk of stopping the diet within a week rather than for six weeks. However, those who have improved between 50-99% and received more drugs have a slightly increased risk of overall seizures.

So, in summary, the ketogenic diet:

* The drug is more effective
* Compliance with diets is higher than most drugs
* Stopping the diet shows that the benefits obtained remain
* Safe to stop the diet relatively quickly if needed

That sounds good to me. However, despite all this, this is considered the last line of approaches to control seizures (especially in children) rather than the first line, if recommended at all. This might be because the overall bad attitude towards diet is a strong player in chronic diseases. Either way, it is no longer possible for doctors to deny the power of food choices in controlling seizures.