The Ketogenic / Atkins Diet

Epilepsy has a few treatments.  Drugs, surgery to remove damaged brain tissue, the ketogenic or Atkins diet, and devices like deep brain stimulation or vagus nerve implant. I’m sure there are others too that work.  Drugs are only a bandaid, unless the epilepsy spontaneously resolves, which mostly happens in kids, not adults.  Drugs work in 2/3 of cases.  After 2 drugs are tried and fail, the chances are very slim that any other drug will work.  Surgery offers the chance of a cure.  The ketogenic diet and the modified Atkins diet also have a chance of curing epilepsy.  Epilepsy is caused by damaged brain cells, whether by a lesion (tumor, scar or injury), genetic/biochemical abnormalities such as mitochondrial diseases, and autoimmune disease.  My son has no lesions on his MRI, no family history of epilepsy, and strong family history of autoimmunity.  So I think his epilepsy is either autoimmune or from brain damage due to prematurity.  Epilepsy drugs can cause sedation, liver toxicity, allergies, bone loss, etc.  I didn’t want my delayed child to be any more delayed.  The first drug we tried had terrible side effects: crying for hours and aggression The second drug, while not as sedating as other epilepsy drugs, is in a class of anti-epileptic drugs (AED’s) known to cause low immunoglobulins, allergy, eosinophilic esophagitis, and Steven Johnson syndrome.  Not a good choice for him.  After he got to a high dose and it didn’t improve his EEG, we decided to try the modified Atkins diet.   I saw miraculous results in a friend’s child with the classic ketogenic diet, who went from intractable epilepsy to no seizures in days.

The basic theory is this: brain cells can run off glucose or ketones.  The brain cells that cause the seizures are more active and use a lot more glucose and can’t use ketones very well.  If you remove glucose from the diet and provide a lot of fat, the body turns the fat into ketones and uses that for fuel.  Normal brain cells are cool with this, but not the seizure cells.  In fact, it may work as a kind of micro-surgery, killing the bad brain cells while the normal cells are fine.  Ketosis is also anti-inflammatory.  The ketogenic diet can be used in a brain cancer called glioblastoma.  The cancer cells have damaged mitochondria and can’t use ketones.  These cancer cells are known to die when they are restricted to using only ketones.

Some people are cured after a period of time on the diets.  I think that’s one of the best reason to try the diet in kids.  Epilepsy itself and the drugs have so many side effects, why not remove one of those things the kids have to deal with.  It’s hard for the parents.  But the modified Atkins diet is showing it’s almost as good as the very difficult ketogenic diet. For us the Atkins diet was pretty tough because my son was still dealing with multiple food allergies, but it was easier that attempting the ketogenic diet, which relies heavily on nuts.

So: no side effects for the kid (except a limited diet), the chance for a cure, healing with food, yeah it’s a pretty good idea in my book.   Another plus of the diet is that it is high fat, and you can use omega 3’s for added brain healing.  I think this should be used in epileptic infants as a first line treatment since a ketogenic formula is available.  Perhaps skimmed breastmilk fat could also be used, provided the mom has a good supply.  Yes it’s a lot of work for the parents, but I am so glad we have had the chance to try this.  I also think this would be a good thing to try in autism, especially the 2/3rds of autistics who have epilepsy or abnormal EEG’s.

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