In a telephone interview with Medscape Medical News, Mary Zupanc, MD, director of the comprehensive epilepsy program and chief of the division of child neurology at the Children’s Hospital of Orange County in Orange, California, explained why she believes that the ketogenic diet is a good treatment practice for children with epilepsy.
The ketogenic diet was created in the 1920s as a treatment for epilepsy. Scientists believe the low glucose and ketosis that occur because of the diet causes changes in the brain’s metabolic pathways, which in turn lessens the number of seizures a patient has. When Medscape asked her how epilepsy is different in children and adults, Zupanc explained that pediatric epilepsy has a different etiology than adult-onset epilepsy, and that the causes are different for each patient. She also explained that child epilepsy exists in two categories: idiopathic (mostly genetic) and symptomatic. In treating both forms of pediatric epilepsy, she explains that the ketogenic diet can be used with little doctor supervision. The reason for that is because the diet changes the neurochemistry of the body.
“The indications for the diet are medically intractable epilepsy, so all types of epilepsy. All types of seizures have been shown to improve, so with the ketogenic diet you can get some efficacy. Then there are specific conditions treated with the ketogenic diet,” says Zupanc in response to what the indications were to the ketogenic diet by Medscape.
As for the diet’s efficacy in reducing seizures, Zupanc says, “It pretty much follows the law of thirds: a third will have a very significant improvement in their seizures, another third may see improvement, and in about a third of the patients, it is either not effective or the side effects become intolerable.”
While studies may need to be conducted to verify Zupanc’s claim, the diet could prove to be a far safer method of controlling epilepsy than using surgeries and drugs like Topamax. With the risk-to-benefit ratio being so iffy with Topamax, which has been linked to serious side effects in babies whose mothers take the drug while pregnant, the ketogenic diet may prove to be a safer alternative. Babies exposed to Topamax in-utero may be born with birth defects including PPHN, oral clefts, cleft palate, neural tube defects, spina bifida and heart, lung and brain defects.
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