So we’ve talked several times about the ketogenic diet and how incredibly effective it is at controlled seizures. The numbers are very consistent in study after study and, quite frankly, are amazing.
So amazing, in fact, that I remain stumped as to why this isn’t the FIRST path of treatment rather than the absolute last. The ketogenic diet is almost always used in refractory seizures, which means that the diet is not used until a vast array of medications have been used and have failed.
The ketogenic diet is similar to the Atkins’ diet, in that it is very high in proteins and fat. The argument against the ketogenic diet is that it is hard to remain compliant with, because apparently having your brain damaged by aberrant firing of neurons is not as important as that slice of bread.
However, recent studies have shown that the modified ketogenic diet, which allows a slightly higher percentage of carbohydrates, is just as effective. This particular study looks at the compliance argument and pretty much bashes it to shreds.
In a long term follow up study of the ketogenic diet in children over 20 years, 65% of the patients remained on the diet. I can tell you that, in terms of medication, to get 64% of patients to be compliant with taking a medication for TWENTY years is practically unheard of.
Further, 20% became seizure free and 36% had a 75–99% decrease in seizures. Overall, 56% of the patients had a seizure reduction of more than 75%. Holy cow!
So what happened to those who didn’t continue the diet? Twenty patients who had become seizure free discontinued the diet, but seizures recurred in five (25%). Of 40 patients with a seizure reduction of more than 50% who discontinued the diet, only 25% presented with recurrent seizures. This means that there was a clear, long lasting benefit to seizure reduction just from being on the diet.
So again, I ask the question about why we use this diet only in refractory seizures. It is exceedingly powerful. Patients who follow the diet are very likely to stay on it long term. AND, it seems to positively change the long term likelihood of having a seizure even in those who discontinue the diet.