Diet changes to help tough-to-treat epilepsy

This article explains low-carb high-fat diets and how they help tough-to-treat epilepsy.

Diets high in fat and low in carbohydrates, such as the ketogenic or modified Atkins diet, may reduce seizures in adults with tough-to-treat epilepsy, according to a review of the research published in the October 29, 2014, online issue of Neurology®, the medical journal of the American Academy of Neurology.

Epilepsy is a nervous system disorder in which the nerve cells in the brain work abnormally, causing seizures. About 50 million people have epilepsy worldwide, according to the World Health Organization.

"We need new treatments for the 35 percent of people with epilepsy whose seizures are not stopped by medications," said study author Pavel Klein, M.B.,B. Chir., of the Mid-Atlantic Epilepsy and Sleep Center in Bethesda, Md., and a member of the American Academy of Neurology. "The ketogenic diet is often used in children, but little research has been done on how effective it is in adults."

The ketogenic and modified Atkins diets include items such as bacon, eggs, heavy cream, butter, leafy green vegetables and fish. The ketogenic diet consists of a ratio of fat to protein/carbohydrates of three or four to one by weight. The modified Atkins diet has a one-to-one fat to carbohydrate/protein ratio by weight.

Scientists reviewed five studies on the ketogenic diet with a total of 47 people included in the analysis and five studies on the modified Atkins diet with 85 people included.

Researchers found that across all studies, 32 percent of people treated with the ketogenic diet and 29 percent of those treated with the modified Atkins diet experienced a 50 percent or better reduction in their seizures. Nine percent in the ketogenic treatment group and 5 percent in the modified Atkins group had a greater than 90 percent reduction in seizures.

The positive results occurred quickly with both diets, within days to weeks. The effect persisted long-term, but, unlike in children, the results did not continue after participants stopped following the diet. Side effects of both diets were similar and not serious, with weight loss the most common side effect.

Fifty-one percent of the ketogenic diet group and 42 percent of the modified Atkins group stopped the diet before the study was completed.

"Unfortunately, long-term use of these diets is low because they are so limited and complicated. Most people eventually stop the diet because of the culinary and social restrictions," said Klein. "However, these studies show the diets are moderately to very effective as another option for people with epilepsy."

Read more here

Ketogenic Diet May Help Children with Epilepsy

This article discusses a ketogenic diet and why it helps children with epilepsy.

A ketogenic diet is sometimes used as a treatment in children with persistent epilepsy that has failed to respond to medical treatment. The diet can be challenging and have adverse side effects, however, so scientists are researching other dietary measures that may help reduce seizures. Researchers with Johns Hopkins Children’s Center have found that periodic fasting may help either in tandem or as an alternative to the ketogenic diet plan.

Epilepsy is a brain disorder in which a person has repeated seizures over time. About 65 million people worldwide (including about 2 million Americans) have the condition. In most cases, there may not be any known cause for the seizures. However some cases of epilepsy may be due to stroke, traumatic brain injury, infections, brain defects present at birth, a brain tumor, or metabolism disorders. Symptoms vary from person to person but could include staring spells or violent shaking and loss of alertness that can last from a few seconds to a few minutes.

As many as 20 to 40 percent of patients with epilepsy have what is known as refractory epilepsy, meaning that it is resistant to antiepileptic drugs. In these cases, children may be treated with a high-fat, low-carbohydrate diet known as the ketogenic diet which causes the body to adopt a “fasting” type state in which it produces ketones, a by-product of fat metabolism. The diet is believed to work by triggering biochemical changes that eliminate seizure-causing short circuits in the brain's signaling system. The diet must be strictly followed and requires a significant commitment to work effectively.

Because the body mimics a fasting state during the ketogenic diet, doctors at Johns Hopkins studied the effect of actual fasting to see if there may be an added benefit or if the treatment could replace the ketogenic diet as a therapy option.

Six children, aged 2 to 7, who were already following the ketogenic diet were asked to fast on alternate days. All six of the kids had seizure disorders that had not completely resolved using the diet alone. After fasting was added to the dietary regimen, four of the six children experienced between 50 and 99 percent fewer seizures.

Based on previous studies in mice, the doctors believe that fasting works on the brain differently than the ketogenic diet, so it could potentially be used as a stand-alone therapy as well. "Our findings suggest that fasting does not merely intensify the therapeutic effects of the ketogenic diet but may actually represent an entirely new way to change the metabolism of children with epilepsy," says lead investigator Adam Hartman, MD, a pediatric neurologist.

"We don't fully understand the reasons for these marked differences,” says Eric Kossoff MD, the director of the ketogenic diet clinic at the Johns Hopkins Children’s Center, “but unraveling the mechanisms behind them will help pave the way toward new therapies for epilepsy, and is the focus of our ongoing work."

Of course, the study is very small and results are preliminary. The researchers caution that larger studies are needed to further evaluate the benefits – and potential consequences - of periodic fasting in children. Parents should discuss all epilepsy treatment with their child’s neurologist before attempting any such therapies.

Read more here

Autism center changes name, location, leaders

Autism center changes name, location, leaders
The Thoughtful House Center for Children — an Austin facility geared to education, research and treatment of children with autism and other developmental disorders — has a new name, address and faces.


It is now the Johnson Center for Child Health and Development, named for Betty Wold Johnson, a prominent donor and member of the family who founded the health care company Johnson & Johnson. On Monday, the center will be move from its longtime Bee Cave Road location to 1700 Rio Grande St., Suite 200.


Thoughtful House was led by Andrew Wakefield until he resigned last year. The medical board in the United Kingdom took away his medical license for his role in a controversial 1998 study that suggested a possible link between autism, vaccines and bowel disease.


Wakefield said last year that he didn't want to be a distraction from the work of Thoughtful House, which he said was getting away from a focus on gastrointestinal issues and autism.

Anissa Ryland, executive director of the Johnson Center, said the organization does not collaborate with Wakefield or a doctor who worked with Wakefield at the center, Dr. Arthur Krigsman.


Another physician who worked with Wakefield and Krigsman, Dr. Brian Jepson, also has left the center.


http://www.statesman.com/news/local/central-texas-digest-autism-center-gets-new-name-1459998.html