When is Ketogenic Dietary Therapy right for me?
Everyone with epilepsy is different. Some management options work well for one person but not for others. Ketogenic Dietary Therapy (KDT) is like this, too. So, could a medical ketogenic diet be an effective management option for you? Here we’ll explore who’s most likely to benefit from this alternative therapy.
When the meds don’t work
Approximately 70% of people with epilepsy effectively manage their seizures with anti-seizure medication (ASMs). But if you’ve tried at least two or more appropriately prescribed ASMs with no success, KDT should be considered, especially if you are not found to be suitable for epilepsy surgery.
Around 30% of people have inadequate control of their epilepsy with ASMs and KDT can be a really effective management option for them. Up to 50% of people who trial KDT experience at least a 50% reduction in seizures and 10% may become seizure free. Other benefits may include the following:
- Having less severe seizures or shorter seizures
- Epilepsy medication may be able to be reduced
- Individuals may show increased alertness, awareness and responsiveness
- Improved quality of life such as increased energy levels and better sleep
Types of epilepsy
KDT is effective in managing a range of different types of epilepsy. Research has shown that KDT can be particularly effective in:
- Angelman syndrome
- Complex 1 mitochondrial disorders
- Dravet syndrome
- Epilepsy with myoclonic-atonic seizures (Doose syndrome)
- Glut 1 deficiency syndrome
- Febrile-infection-related syndrome (FIRES)
- Infantile spasms
- Ohtahara syndrome
- Pyruvate dehydrogenase deficiency (PDHD)
- Super-refractory status epilepticus (SRSE)
- Tuberous sclerosis complex (TSC)
KDT and other dietary requirements
It is possible to adapt the diet to a wide range of dietary requirements, including avoidance of allergens such as dairy, nuts and eggs and those who are fed via a tube. Your dietitian can also adapt the plan to take account of ethnic diets and food preferences such as following a plant-based diet. So, you should be able to find some foods that you like – whatever your needs.
When KDT isn’t suitable
For some people, a KDT is not the right management option. This includes people who have problems with ketone metabolism, or those who need a high-level carbohydrates in their diet as part of their management. Sometimes, KDT is possible but may be more challenging – for example, if you have a lot of food allergies. Check with your healthcare professional if you are worried or unsure.
Important note: Don’t try this at home without medical supervision
KDT isn’t like a diet you might try for weight loss. It’s a highly tailored eating plan that is designed differently for everyone, with a dietitian working out exactly how much of each food type you need to be eating for your age and circumstances to ensure you meet your individual nutritional requirements. It’s really important for you to be closely monitored by healthcare professionals throughout your journey on KDT. So always speak to your healthcare professional and never start a ketogenic diet without their knowledge or support.