A controlled diet could cut epileptic seizures by 90%

Proof of ketogenic diet efficacy raises hopes for epilepsy patients.

Children with epilepsy should have better NHS access to a special diet proven to prevent seizures, say UK researchers.

The call comes after the first randomised trial into the ketogenic diet showed it cut seizure rate by 50-90 per cent in children with poorly controlled epilepsy.

The ketogenic diet has been used to control drug-resistant epilepsy since the 1920s, but doubt over its value remains.

It is managed by a dietician and has a high-fat, low-carbohydrate content to boost production of ketone bodies, rather than sugar, to fuel the brain.

The latest study involved almost 150 children, aged two to 16 years. They all had severe epilepsy, suffering a fit daily, and had failed to respond to at least two antiepileptic drugs.

Half were randomised immediately to the ketogenic diet but the therapy was delayed for three months in the other half.

Complete data was available for 54 children in the diet group and 49 controls. Compared with baseline, 38 per cent fewer seizures were recorded in the diet group. But 37 per cent more fits noted in controls.

Seizure rate halved in 38 per cent of the diet group, compared with 6 per cent of controls. Seven per cent in the diet group had a 90 per cent fall.

Side-effects included constipation, vomiting and hunger.

Dr Elizabeth Neal, a research dietician at the Institute of Child Health in London and part of the study team, said the ketogenic diet is not used enough.

'It does take a lot of dietetic time so it takes a lot of resources,' she said. 'Another (thing) is an awareness issue.'

Although access to the ketogenic diet should be quicker, it needs to be restricted to children who have failed to respond to two medications, she added.

rachel.liddle@haymarket.com

Lancet Neurology Online

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