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      HealthWACH: Fighting Epilepsy

      COLUMBIA (WACH)

      Sometimes clustered or prolonged seizures (usually 30 minutes or longer) develop into non-stop seizures, resulting in a condition called status epilepticus. It is a condition that is a medical emergency because the longer a seizure lasts the less likely it is to stop on its own. Any type of seizure can become status epilepticus and it could lead to brain damage, or even death.

      The Ketogenic diet has been used since 1921 to treat several forms of epilepsy in patients who don??t respond to anti-seizure medications. It is a diet made up of high-fat foods and very few carbohydrates. It works by triggering biochemical changes that eliminate seizure-causing short circuits in the brain??s signaling system. Anecdotal evidence also suggests the diet be used in the treatment of brain tumors, Alzheimer??s, stroke and Parkinson??s disease, and several human and animal studies have found tumor reduction after treatment with this diet. Researchers suspect that cancer cells require glucose for survival, and the ketogenic diet deprives them of this necessary fuel. One report described two children with inoperable brain cancer, whose tumors shrank remarkably after treatment with the ketogenic diet, leading to long-term survival of both patients. This evidence shows that the diet may affect the body??s chemistry on a far more basic level than once believed. What is well-established is that when it comes to seizures, the diet??s therapeutic effects last longer than those of medication.

      The most common misconceptions about the diet are that it causes dangerous biochemical changes, is inappropriate for use in infants and very young children, causes weight gain and fatty build-up in the arteries, and that it should be a treatment of last resort. John Freeman, MD, and Eric Kossoff, MD, Pediatric Neurologists at Johns Hopkins Children??s Center, say that all are partly or entirely false. The diet does require monitoring by a dietarian and a neurologist, which also may discourage patients and health-care professionals from using it. Several studies have shown the effectiveness of the diet in reducing or eliminating seizures entirely. In a 2001 Hopkins study, 75 out of 83 children who were on the diet for a year experienced full resolution or partial reduction of seizures. Many of them continued to do well even years after stopping the diet. Dr. Freeman and Dr. Kossoff say the diet does have side effects. They include vomiting and constipation, and a temporary moderate spike in cholesterol, which will go down after one to two years on the diet. The doctors also recommend the diet as a first-line treatment in two rare metabolic conditions??Glut-1 deficiency and pyruvate dehydrogenase deficiency, both marked by seizures and other neurological problems.