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Treatment Spotlight: The Ketogenic Diet and Epilepsy in Children

Children's Health
Author name: Lee Health


Nearly a year ago, 3-year-old Anthony Vento was walking along a beach with his mother when he stumbled and fell. Toddlers growing into their bodies often do, especially when their coordination is challenged by the soft and shifting sands of a beach. 

“It actually came out of nowhere,” recalls the boy’s father, Anthony Vento. “He was totally fine, completely healthy.”

But the fall wasn’t a one-time occurrence. During the next few weeks, the falls continued until one night, Anthony experienced a grand mal seizure, a type of seizure that involves a loss of consciousness and violent muscle contractions.

Doctors diagnosed Anthony with epilepsy.

According to the Centers for Disease Control and Prevention, about 470,000 children ages 0-17 in the U.S. have active epilepsy. About 50 percent to 60 percent of children with seizures will eventually grow out of them and never experience seizures as an adult.

In the brain, nerve cells communicate with each other through electrical activity, says Dr. Jose Colon, board-certified both as a pediatric neurologist and sleep medicine physician with Lee Physician Group. A seizure occurs when one or more parts of the brain has a burst of abnormal electrical signals that interrupt normal brain signals.

“Anything that interrupts the normal connections between nerve cells in the brain can cause a seizure,” Dr. Colon explains. “High fever, high or low blood sugar, alcohol or drug withdrawal, or a brain concussion are some causes. Typically, we diagnose a child who has two or more seizures as having epilepsy.”

Antiepileptic medication can offer symptom relief, while others may require more invasive surgical treatments. Doctors tried to stop Anthony’s seizures with medications, but none worked.

Dr. Colon says 30 to 40 percent of people with epilepsy will continue to have seizures despite treatment due to medication-resistant epilepsy, a condition medically known as refractory epilepsy. In such cases and when surgery also isn’t an option to control the seizures, alternative therapies are available, like the ketogenic diet.

What is the ketogenic diet?

The ketogenic diet is a ratio of high fat, moderate protein, and low carbohydrate used as a non-pharmacologic (non-medication) therapy for refractory epilepsy. More specifically, the diet recommends eating 70 to 80 percent fat, 10 to 25 percent protein, and very minimal carbs and sugars, Dr. Colon explains.

“The ketogenic diet is a therapeutic diet that studies show can reduce seizure frequency in about 50 percent of children after three months under diet, about 15 percent of whom become seizure free,” Dr. Colon says.

Dr. Colon recommended Anthony try the ketogenic diet. Marissa Vento, Anthony’s mother, was familiar with the “keto diet” as the popular low-carb diet, like the Atkins diet, where users get more calories from protein and fat and less from carbohydrates.

“I wasn’t familiar with the ketogenic diet at all,” she says. “I knew everyone uses it to lose weight but I never heard of it medically.”

Because the amount of carbohydrate and protein are restricted in it, the ketogenic diet requires that users carefully weigh and measure calories, fluids, and proteins of all foods.

The body typically uses carbohydrates, such as sugar, bread, pasta, for fuel. Because the ketogenic diet is extremely low in carbohydrates, fats become the primary fuel instead, Dr. Colon says. When the body breaks down fat for its source of energy, it makes chemicals called ketones, which the brain and heart use as an energy source.

Researchers aren’t exactly sure why the diet works, but it does in some children, like Anthony. Within a few days of adopting the dietary lifestyle change, his seizures stopped.

“I truly believe the ketogenic diet is why our son ... is back in school, happy, and seizure-free,” says Anthony Sr.

The proof is in the low-carb pudding: “It makes me feel better,” says Anthony Jr.

When to see an epilepsy specialist

If you’re concerned that your child has had a seizure, schedule an appointment with one of our board-certified pediatric neurologists who can help you determine if there is a trigger.

Once a child has had a seizure, their risk increases for having more. A child who has had one seizure has about a 45 percent risk of having a second one. If they have had two seizures, the risk for a third seizure increases to 75 percent to 80 percent.

You’ll benefit from the support of our board-certified experts and licensed dietitians who will work together with you and your child to discuss the latest in surgical and non-surgical treatment options.

Call Golisano Children’s Hospital of Southwest Florida at 239-343-KIDS (5437) today.

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