When a child’s epilepsy and seizures do not respond to medicines, eating a ketogenic diet may help reduce the frequency of seizures. A ketogenic diet is an eating plan that is high in fats, supplies adequate protein and is very low in carbohydrates. The ketogenic diet requires precise measurement of foods and is only used under medical supervision.
Eating a high fat, low carbohydrate diet changes the way energy is used in the body. The liver turns the fat into fatty acids and ketone bodies, which are used as energy instead of carbohydrates. A higher level of ketone bodies in the blood helps reduce the number of seizures.
Types of seizures that respond well to a ketogenic diet include:
When children begin a ketogenic diet under the care of doctors at Riley at IU Health, they are admitted to the hospital for close monitoring by the ketogenic therapy team, which includes a neurologist, dietitian, pharmacist and nurse. The child will fast by eating nothing after midnight. During the hospital stay, parents are taught how to prepare ketogenic meals and how to monitor their child’s nutrition.
A ketogenic diet can be challenging, as it requires strict compliance and patience. It takes three months to adjust to a ketogenic eating plan:
In some cases, the less restrictive modified Atkins diet (MAD) may be recommended instead. This eating plan does not require a hospital stay and can be followed without the need to measure or weigh food and count calories. The MAD should still be used under medical supervision as blood draws are needed to monitor a child’s progress. The modified Atkins diet generally lowers seizure rates within a few months.
The ketogenic therapy team at Riley at IU Health will work closely with you and your child to help you follow this nutritional plan. Once the ketogenic diet is fine-tuned to your child's specific needs, he or she will meet with the ketogenic therapy team once every three to six months for monitoring and to make any needed adjustments.
More than half of all children who go on the ketogenic diet see a 50 percent reduction in the number of seizures. Between 10 and 15 percent of children become seizure-free.
If your child’s epilepsy does not respond to other treatments, his or her neurologist may refer you to the ketogenic therapy team. You and your child will meet with a neurologist and dietitians who will explain how the ketogenic diet works.
You can expect the following before your child starts a ketogenic diet:
You can expect the following when your child begins a ketogenic diet:
You can expect the following in the months after your child begins a ketogenic diet:
If your child is using the modified Atkins diet:
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