Two high-fat diets — the classic ketogenic and a modified version of the Atkins — can reduce and, in some cases, completely eliminate seizures in children with a common seizure disorder known as absence epilepsy, say researchers from Johns Hopkins Children’s Center.
Their report, published online July 20 in the Journal of Child Neurology, shows that more than 70 percent of the patients treated with either the ketogenic or the modified Atkins diet experienced at least 50 percent fewer seizures, and many showed as high as 90-percent improvement.
Absence epilepsy, so named after the multiple daily “absent” staring spells typical of the disorder, usually begins in childhood. But when developed during adolescence, absence epilepsy can also lead to more serious generalized seizures.
The ketogenic diet has been used since 1921 to successfully treat several forms of epilepsy in patients who don’t respond to antiseizure medication. Made up of high-fat foods and few carbohydrates, the diet works by triggering biochemical changes that eliminate seizure-causing short circuits in the brain’s signaling system. In 2003, Hopkins Children’s researchers reported that a modified version of the popular low-carbohydrate, high-fat Atkins diet can control seizures nearly as well as the more restrictive ketogenic diet.
“We already knew these diets worked well for several other types of epilepsy, but our new findings bring more good news — children with absence epilepsy who don’t respond to antiseizure medications can also benefit from these dietary approaches,” says senior investigator Eric Kossoff, M.D., a pediatric neurologist and director of the ketogenic diet program at Hopkins Children’s.
Because some pediatric neurologists may see absence epilepsy as a fairly benign condition that many children outgrow, they may resist putting a child on a restrictive diet, Kossoff says. Given that some children continue to have seizures well into their teen years, researchers say, their doctors should at least discuss the modified Atkins as an easier-to-follow alternative to the ketogenic diet.
The investigators’ recommendations are based on observations of 21patients with absence epilepsy treated with either diet at Hopkins Children’s, as well as on an exhaustive review of all studies on the subject published between 1922 and 2008.
Of the 21 Hopkins absence-epilepsy patients who were treated between 1993 and 2009 with either the ketogenic or the modified Atkins diet, 76 percent reported at least half as many seizures with one month of being on the diet. Nearly 40 percent of them reported 90 percent fewer seizures, while nearly 20 percent became seizure-free. After three months of diet treatment, 82 percent had at least a 50-percent reduction in the number of seizures, nearly half of the patients had 90 percent fewer seizures, and nearly 20 percent had no seizures at all. Both diets worked equally well.
Among the 133 patients described to date in the medical literature, 69 percent experienced at least 50 percent or greater reduction in the number of daily seizures, and 34 percent became seizure-free for at least a period of time. Some patients improved within three days of starting the diet, while others didn’t do so until three months later.
Co-investigators include Laura Groomes, Paula Pyzik, Zahava Tuner, Jennifer Dorward, and Victoria Goode, all of Hopkins.
The study was funded in part by the Carson Harris Foundation, the National Institutes of Health, and the Dr. Robert C. and Veronica Atkins Foundation and Nutricia Inc.
Conflict of interest disclosure: Dr. Kossoff has received grant support from Nutricia, Inc., and consultant fees from Nutricia and Atkins Nutritionals Inc., none of which were related to this study. The terms of these arrangements are being managed by the Johns Hopkins University in accordance with its conflict-of-interest policies.