Epilepsy, a brain disorder causing recurrent seizures, affects 2.3 million U.S. adults and 467,711 children, according to the Centers for Disease Control. Epileptics can support their drug regimen’s effectiveness by watching what they eat. A high-fat, adequate-protein, low-carb ketogenic diet or less-restrictive modified Atkins diet help control or reduce seizure frequency.
Strict compliance with the drug regimen your doctor prescribes is the best seizure prevention. These common anti-epileptic drugs (AEDs) act as anticonvulsants.
Carbamazepine (Tegretol, Equetro, Carbatrol) is a single and add-on drug for many epilepsy syndrome types.
Clonazepam (Klonopin) controls myoclonic and atonic seizures other drugs can’t. It also treats Lennox-Gastaut epilepsy syndrome.
Ethosuximide (Zarontin) manages petit mal seizures if you haven’t experienced other types.
Gabapentin (Neurontin) is an add-on drug for complex and generalized partial seizures.
Lamotrigine (Lamictal) is a single and add-on partial-seizure drug. It’s also an add-on treatment for generalized seizures associated with Lennox-Gastaut syndrome and grand mal seizures.
Levetiracetam (Keppra) comes in oral and intravenous forms as add-on therapy for many seizure types.
Oxcarbazepine (Trileptal) is a single and add-on partial-seizure medication.
Phenobarbital (Luminal) and primidone (Mysoline) barbiturates prevent grand mal and partial seizures.
Phenytoin (Dilantin) treats grand mal and partial seizures, status epilepticus and high seizure-risk head injuries.
Pregabalin (Lyrica) and zonisamide (Zonegran) are add-on partial-seizure medications.
Tiagabine (Gabitril) is similar to phenytoin and carbamazepine.
Topiramate (Topamax) is a single and add-on drug for grand mal and partial-onset seizures plus seizures associated with Lennox-Gastaut syndrome.
Valproate (Depakene, valproic acid) and delayed-release divalproex sodium (Depakote) treat generalized seizures and prevent nearly all other major seizures.
Diet History and Studies
Ancient Greeks noticed how fasting controlled seizures. The ketogenic diet became popular with children in the 1920s. By 1930, study participants included teenagers and adults. The Mayo Clinic reported 56 percent of older patients improved on the diet and 12 percent stop experiencing seizures. Doctors recommended this diet less when anticonvulsant drugs become routine treatments in the 1950s. But for the 20 to 30 percent of people who can’t control seizures adequately with prescription drugs today, the specially formulated ketogenic diet has resurfaced as an important epilepsy management tool.
A new McGill University and University of Zurich study discovered an unexpected link between metabolism in brain cells and their ability to transmit signals. Metabolism controls the processes that inhibit brain activity, including those involved in epileptic convulsions. Other recent studies show a ketogenic diet reduces seizures by at least 90 percent in about one-third of patients. Another third experience a 50- to 90-percent improvement.
Around 2003, parents and patients discovered the high-protein, low-carbohydrate Atkins diet’s induction phase controlled seizures. Johns Hopkins Hospital’s ketogenic diet team modified the Atkins diet by removing its weight-loss goal, indefinitely extending its induction phase and encouraging fat consumption. Studies show the modified Atkins diet reduces seizure frequency by over 90 percent in 27 percent of patients and by over 50 percent in 43 percent of epileptics.
The Ketogenic Diet
The calorie-limited ketogenic diet combines very high-fat (90-percent), adequate-protein (just enough for body maintenance and growth) and very low-carbohydrate amounts so your body will burn fats instead of carbohydrates. Your liver converts fat into fatty acids and ketone bodies. The ketones pass into your brain, replacing glucose as your energy source. An elevated ketone level in your blood, known as ketosis, reduces epileptic seizure frequency.
A nutritionist may begin your professionally monitored ketogenic diet with a fast or hospitalization. The typical starting ratio of fat grams to protein (based on your age) plus carb grams is 4-to-1. For at least 90 percent of your calories to come from fat, increase your consumption of high-fat foods such as nuts, cream and butter. Exclude high-carbohydrate foods like bread, grains, pasta, sugar and starchy fruits and vegetables.Ban packaged low-carb foods (shakes, bars, etc.) for at least the first month. This strict diet requires weighing, measuring and recording foods and beverages. Follow this diet carefully; any slight deviation can provoke a seizure.
The following is a typical day’s menu. In recent years, some variations substitute coconut oil or medium-chain triglyceride (MCT) oil for some of the heavy cream and butter.
Breakfast. Make an omelet with heavy cream, butter and bacon. Drink cocoa with cream.
Lunch. Serve tuna salad made with mayo and heavy cream on lettuce.
Dinner. Eat a salad (lettuce, celery and cucumbers) with mayonnaise, fatty steak, broccoli or cauliflower with cheese and artificially sweetened sundae with whipped cream.
Snacks. Make keto custard with egg and heavy cream. Create keto yogurt with sour cream, heavy cream and a little fruit. You can also enjoy peanut butter balls by mixing peanut butter with butter.
Modified Atkins Diet
This less-restrictive alternative doesn’t begin with fasting or a hospital stay. You need less dietitian support and don’t have to measure your intake. The modified Atkins diet’s initial adult carbohydrate limit is 20 grams per day. After a month, slowly increase it to 30.
Before beginning either diet, consult your doctor to see if it interferes with your anti-epileptic medications. If you receive your doctor’s approval, you can start lowering your seizure frequency by modifying your eating habits.