Ketogenic Diet for Epilepsy and Other Neurological Disorders




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In recent years, clinicians have utilized a somewhat surprising tool to treat their patients with refractory epilepsy-diet. The majority of people with epilepsy can become free from seizures with the use of antiepileptic medications, but in about 20-30% of people with epilepsy, medications fail to completely control their symptoms. Clinicians and researchers have found the ketogenic diet is an effective way to treat these patients; it is at least as successful as the most recent anticonvulsant drugs designed to treat refractory epilepsy. Researchers have also started exploring the therapeutic potential of the diet in other neurological conditions, including Alzheimer’s disease, Parkinson’s disease, and Amyotrophic Lateral Sclerosis (ALS), among others.

The ketogenic diet is low in carbohydrates, adequate in protein, and high in fat, and sometimes partially restricted in calories. When following this diet, the brain shifts its main source of energy from glucose to fat. Fats are broken down into ketones, and these ketones are utilized by the brain as its main energy source. This shift in energy source is thought to be related to decreased seizures, though exactly how this happens is not yet clear. Researchers have proposed that the diet may work by altering neurotransmitter function, synaptic transmission, regulation of reactive oxygen species, and mitochondrial dysfunction — pathological mechanisms thought to play a role in a number of neurological diseases.

In Alzheimer’s disease, for example, results from clinical studies have been inconclusive but promising. In one randomized double-blind study, Alzheimer’s patients on a ketogenic diet showed significant cognitive improvement compared to patients not following the diet. In cell cultures, ketone bodies have been shown to be effective against the toxic effects of beta-amyloid, a key pathological feature of the disease. The diet may also help reduce oxidative stress and enhance mitochondrial function.

Mitochondrial dysfunction is also thought to play a contributory role in Parkinson’s disease, with its characteristic movement and cognitive impairment. In one small clinical trial of five patients with Parkinson’s disease, patients on the diet reduced their scores on the Unified Parkinson’s Disease Rating Scale by 43.4%.

The diet may also prove helpful in the treatment of Amyotrophic Lateral Sclerosis, or ALS. Mitochondrial dysfunction is also likely to play role in this devastating disease of the motor neurons. Though human studies have not yet been performed, mouse models of the condition have yielded promising results. In these mouse models, animals given a ketogenic diet showed significant motor improvements compared to animals on a normal diet.

Researchers speculate that the diet may prove helpful in even more neurological conditions, such as recovery from stroke and brain injury. Though the diet is an accepted treatment for refractory epilepsy, in other neurological conditions more clinical trials are needed to see if the diet is truly efficacious. If borne out, the diet may open another therapeutic avenue for the treatment of these diseases.

References

Griggs RC. Epilepsy. In Andreoli TE, Carpenter CC, Griggs RD, Benjamin IJ, eds. Andreoli and Carpenter’s Cecil Essentials of Medicine. 7th Ed. Philadelphia, PA: Elsevier; 2005: 1120-1128.

Henderson ST, Vogel JL, Barr LJ, Garvin F, Jones JJ, & Costantini LC (2009). Study of the ketogenic agent AC-1202 in mild to moderate Alzheimer’s disease: a randomized, double-blind, placebo-controlled, multicenter trial. Nutrition & metabolism, 6 PMID: 19664276

Huffman J, & Kossoff EH (2006). State of the ketogenic diet(s) in epilepsy. Current neurology and neuroscience reports, 6 (4), 332-40 PMID: 16822355

Lee M (2012). The use of ketogenic diet in special situations: expanding use in intractable epilepsy and other neurologic disorders. Korean journal of pediatrics, 55 (9), 316-21 PMID: 23049588

Mackay MT, Bicknell-Royle J, Nation J, Humphrey M, & Harvey AS (2005). The ketogenic diet in refractory childhood epilepsy. Journal of paediatrics and child health, 41 (7), 353-7 PMID: 16014140

Stafstrom CE, & Rho JM (2012). The ketogenic diet as a treatment paradigm for diverse neurological disorders. Frontiers in pharmacology, 3 PMID: 22509165

VanItallie, T., Nonas, C., Di Rocco, A., Boyar, K., Hyams, K., & Heymsfield, S. (2005). Treatment of Parkinson disease with diet-induced hyperketonemia: A feasibility study Neurology, 64 (4), 728-730 DOI: 10.1212/01.WNL.0000152046.11390.45

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  • Amy Renold

    Thanks for this awesome post. I hope this refractory epilepsy-diet would be good for those who are taking epilepsy medicine. What I mean to say is that maybe it is possible to switch over to this diet from the medicine and get rid of those pills.

    Is that possible to get the details, like where can we get it from or if we are supposed to prepare it ourselves then what are the ingredients?

    Thanks

  • http://www.nrsign.com NR Sign EEG

    I attended a recent lecture on this very topic. It seems this kind of diet is becoming popular once again. Of course the pharmaceutical companies will want to share their opinions and FUD on this topic before it becomes known that diet rather than medication could be the answer.

  • JG Christian

    Mitochondrial dysfunction seems to be at the root of many conditions. So does excess carbohydrates. A good friend of mine has refractory epilepsy. He quit the nasty drugs that weren’t working, and tried supplementing with biocritical priora instead, because it helps mitochondria. He was seizure free for about 2 months, the longest time in years. Unfortunately the seizures came back eventually, but maybe the Keri diet and priora might help.

  • http://nutrifriendly.com/ Daisy Anne

    It sounds very comforting to know that the natural possibilities of controlling seizures, for example, is getting more comprehensible. Though the use and the technical process of ketogenic diet may not be fully explained, I am glad at least that the shifting of an energy source is found to be a good way of decreasing and controlling the symptoms. I would be glad to hear about the final reports about it.

  • Sanpanza

    Fascinating because I recently started including a lot more animal protein and fat in my diet as an experiment to deal with insomnia. While it does not have an effect on my insomnia it had the odd effect of significantly reducing my ADHD symptoms significantly.

    I don’t understand the relationship of fat to brain function or ADHD for that matter nor have I ever heard of fat being used for this purpose. The end result for me is that I can sit for long periods of time without fidgeting, my memory has improved and I am more effective.

  • http://www.squidoo.com/nutrilite3 Doc_Mo

    Thanks for a very informative post. I think as research continues, we are going to find even more evidence in the causal relationship between diet illness and health.

  • http://thehealthyarizonan.blogspot.com The Healthy Arizonan

    Amazing article much needed information as there are quite a few Epileptics that the medication just does not work for them. This article is very informative as well as thorough. The info is much appreciated as this is a topic that needs addressing within the medical community. The information in this article is the basis for a lot of neurological issues not fully understood. Thanks again for the information.
    P.S. The references were great!

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  • anne

    Hey There! Thanks for this helpful article. By the way, I hear a lot of people keep on talking about ketogenic diet, but I’m not sure if it is really good. Have anyone tried using ketogenic diet? I’ve heard some unbelivable things about it and my friend lost a lot of weight with it.

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  • Roby

    It is also effective in migraine!

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Ruth J Hickman, MD

Ruth J. Hickman, MD, is a freelance medical, science, and heath writer. Her writing spans the biomedical sciences, but she is particularly interested in immunology, neurology, and genetics. She holds a BA from Kenyon College, where she studied philosophy and neuroscience. She earned a medical degree from The Indiana University School of Medicine, where she received honors in both her neurology and psychiatry rotations. Prior to medical school, she worked in biomedical science and neuroscience labs at University of Illinois at Chicago and at The Ohio State University. She has also previously worked as a patient care technician for individuals with mental illness.
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