Few neurologists, as a front line discussion, will bring up the ability of anything other than medications to alter seizure susceptibility. There is rarely discussion of stress management, exercise, targeted nutraceuticals, avoidance of excitotoxins like MSG and Nutrisweet. There is rarely a discussion of the power of diet; specifically the ketogenic diet.
A decade ago, few would have understood or even heard of the ketogenic diet. However, due to the similarities to the popular Atkin’s diet, most would find the carbohydrate restrictions of the ketogenic diet familiar.
When it comes to seizure control, the ketogenic diet is amazingly powerful. Consistently across studies, 1/3 of those on a ketogenic diet have >90% seizure reduction and another 1/3 have >50% reduction. This is powerful stuff. Far, far more effective than any anti-seizure medication available. And yet it is considered as a last line of approach to seizure control (especially in children) instead of the first line.
The strict carb restriction, tendency towards constipation and the concern over certain nutrients deficiences lead many to think that this is a tough program to follow. This is one of the frequent reasons cited as to why it is so uncommonly used.
Surprisingly, there is little research into why the ketogenic diet is effective. We can through billions at developing new drugs, but can’t spend pennies on a study of diet. We do know that a less strict version such as the modified Atkin’s diet can provide similar seizure control and is more tolerable. We know that the increase in polyunsaturated fat intake (think olive oil and nuts) plays a large role in the seizure reduction.
This particular article begins to delve even more intently into the cellular mechanisms of the ketogenic diet and determine that the adenosine A1 receptor may be a target by increasing the amount of adenosine, which is a potent molecule already known to be involved in seizure prevention in animals. (http://www.jci.org/articles/view/58391)
The more we know about how the ketogenic diet works, the more we can tease apart the aspects of the diet that are important and keep the aspects the are critical. This may increase not only the effectiveness, but the palatability of the diet as a lifestyle.