Childhood epilepsy: Κετογόνος diet instead of drugs?

The diagnosis of epilepsy in children is undoubtedly filled with suspense and fear in the family. However, 80% of children eventually…
you will be relieved of crises and only a smaller percentage of 15% it will take years of medication due to resistant in the treatment of seizures.
“To be clear at the outset that this is not a mental illness and that in most cases it is treated successfully with drugs. As with other diseases, there are many types of epilepsy. Some are mild and easily treated, while others are more complex and selected. In children the most common type of epilepsy is benign and mild and sometimes you don’t need to be treated with drugs. However, in the case of επιπλεγμένης epilepsy require special management program of the child,” explains the Minas Kapetanakis, MD, PhD c, a Pediatrician-an expert Παιδονευρολόγος, Phd Παιδονευρολογίας at the University of Lund, Sweden and a member of the Neurological Company, Sweden.
As “complicated” is characterized epilepsy in which the patient is not responding to medication for the prevention and management of crises, when the crises are frequent and worsening, as well as when epilepsy interferes with the functionality of the individual on a daily level.
In the last few years, especially for children with resistant to medication seizures, shall apply the so-called κετογόνος diet. It is a popular dietary regimen the decades of 1920 and 1930, but was abandoned later as it gained ground in the anti-epileptic drugs.
“Today, the κετογόνος diet is used for the treatment of επιπλεγμένης of epilepsy in children, when the pharmacological therapy alone has not been successful. But, it seems to be effective in all types of epilepsy, by improving the general condition of the patient, reducing the frequency of seizures, and sometimes bringing them in complete control. Yes, a percentage of children might gradually stop taking medication,” notes Dr. Kapetanakis.
The treatment requires that the child, for a specific time period, follows a carefully calculated diet, high in fat, covering the daily needs in proteins and offers the minimum in carbohydrates. In particular, it is usually made up of 80% fat and 20% carbs and protein and it is customized to provide the same quantity of calories compared to the diet that he made in relation to the weight and age of the. The fat provided by the diet is altered in the liver in κετονοσώματα, which the body uses as its main source of energy.
“Simply put, the patient is in a state of counterfeit catabolism and secretes, due to the diet, a large quantity of ketones in the urine. Nevertheless, the pH in the blood is normal, the excess base is normal or low and the blood sugar at normal levels. The treatment is always done in the hospital, as the child may display hypoglycemia and/or metabolic acidosis. Later, when you continue the diet at home can present constipation, nausea, lack of weight gain and height and in some cases of nephrolithiasis. This, however, side effects are completely manageable, but indicate that the assessment of treatment with κετογόνο diet should be done at regular intervals” emphasizes the expert.
One of the main factors for the success of the treatment with the κετογόνο diet is the right information and the assistance of parents and the whole family of the patient. “Parents need to understand that the diet requires planning, that the food must be weighed and that this diet must be strictly adhered to. For this reason the beginning of the therapy the parents be able to meet the παιδονευρολόγο and the dietician together,” adds Dr. Kapetanakis.
For the application of κετογόνου diet required assessment of the growth curve of the child, recording of seizures for three months before the start of treatment, as well as maintenance for the child from their parents for four days before the start of treatment. “The goal of these measurements is the detailed information of the attending physician with regard to the amount of calories you receive daily the child, as well as the dietary preferences.”
At the start of the κετογόνου diet becomes compulsory admission to hospital. The child should be hungry in the first 24 hours, in order to make the necessary blood tests. Adequate hydration is ensured by saline.
“The diet is introduced gradually from the second day. The amount of fat increases gradually to a final level which differs from child to child. The relationship of fat to protein and carbs is about 3:1 in younger children and 4:1 in the largest. The first few days of application of the diet is given at the same time the opportunity for parents to gain information about the design, the details and any side effects that can occur during treatment. Most children can be discharged from the hospital after four days and continue the diet at home with frequent contact with the παιδονευρολόγο and the dietitian on an external basis. The diet is followed for at least three months and usually for a year,” concludes Dr. Kapetanakis.
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