Epilepsy is a disease that affects approximately 50 million people worldwide and is characterized by recurrent seizures. These seizures cause involuntary movement in parts of the body or the entire body and can lead to a loss of consciousness. Although antiepileptic drug (AED) therapy stops seizures in most individuals, studies estimate that 30% to 40% of patients become resistant to treatment with AEDs, a condition known as drug resistant epilepsy (DRE). While the exact cause for DRE is unknown, one potential treatment that has been explored is dietary therapy.
Dietary therapy, used in conjunction with seizure medications, improves the therapeutic effects of AED treatment. It can also be used as a management option for those suffering from DRE. One common diet used for epileptic dietary therapy is the ketogenic diet. The ketogenic diet is a high fat, low carb diet that can be prescribed by a physician and is usually monitored by a dietician. In this diet, the body relies on the breakdown of fats rather than carbs for energy. These fats are metabolized into ketones and ketone bodies, which are able to cross the blood-brain barrier and enter the brain where it can be used for energy. Some food choices specific to this diet include butter, heavy whipping cream, mayonnaise, and oil (e.g., canola or olive). However, this diet is more commonly recommended for children, as it is more difficult for adults to follow such a strict diet plan.
Despite the difficulty in maintaining the diet, it has proven to be extremely effective. Research has shown that the ketogenic diet typically reduces the number of seizures by 50% or more in half of patients. This occurs because epilepsy, and seizures in general, are often caused by higher levels of glutamate and GABA—excitatory neurotransmitters—in the brain. However, the ketogenic diet reduces the amount of glutamate in the brain and lowers the production of GABA. The exact mechanism by which this occurs remains an active area of research, but it opens the door to a compelling question: what other diseases might be effectively treated or cured through dietary therapy?
Reviewed By: Ashley Gutierrez-Torres
Citations:
“Drug Resistant Epilepsy.” Epilepsy Society, 3 Aug. 2023, epilepsysociety.org.uk/about-epilepsy/drug-resistant-epilepsy.
“Ketogenic Diet.” Epilepsy Foundation, www.epilepsy.com/treatment/dietary-therapies/ketogenic-diet. Accessed 30 Nov. 2024.
“Epilepsy.” World Health Organization, World Health Organization, www.who.int/news-room/fact-sheets/detail/epilepsy. Accessed 30 Nov. 2024.
Wnuk, Alexis. “How Do Ketogenic Diets Help People with Epilepsy?” BrainFacts.Org, www.brainfacts.org/diseases-and-disorders/epilepsy/2018/how-do-ketogenic-diets-help-people-with-epilepsy-081418. Accessed 30 Nov. 2024.
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