Epilepsy is a condition where an individual is prone to have recurrent seizures. It is not a single condition but a group of disorders where recurrent seizures are the main presentation. Highest risk of epilepsy is in the first two years of life of the group of children who undergo maximum spurt in neuro-cognitive development. Hence it is imperative to control seizures at the earliest to maximise their development. Standard management of epilepsy is by using anti-epileptic drugs. It is a well-known fact that only 60–70% of children with epilepsy have their seizures controlled with anti-epileptic medications. The rest 30–40% will continue to have seizures irrespective of medications used.
This is a group of children who require constant attention to medications, monitoring development and managing seizure frequency. This invariably puts a huge stress and socio-economic burden on parents and family. It is therefore imperative that we consider the use of all available treatment strategies in helping these children. Ketogenic diet is an alternative therapy for certain types of epilepsy which are difficult to control.
Ketogenic diet is a high fat, low carbohydrate and adequate protein diet, which helps the body produce ketosis, that is helpful in controlling seizures. This diet mimics the body into being starved, and compels the body to use ketones over sugars, which seems to have a stabilising effect on abnormal electrical activity in the brain. Ketosis is a natural mechanism in the body when we starve. The body produces ketones as an alternative energy source for the brain to use in the absence of sugars. Ketogenic diet does it without forcing the person to fast.
Like everything else in life, it has its risks and benefits. In addition to helping in reducing seizure frequency and intensity, it helps in the general improvement in the quality of life such as alertness, cognitive response and development.
(The author is consultant paediatric neurologist, Aster CMI Hospital)