FOOD INTOLERANCE NETWORK
FACTSHEET
Epilepsy,
diet and behaviour
Epilepsy in children and
adults is frequently associated with ADHD-type behavioural symptoms. Trials of
both the Few Foods and the ketogenic low carbohydrate diet have found that
symptoms of both behaviour and epilepsy can improve on restricted diets
although epilepsy without behaviour problems is unlikely to improve.
The Few Foods diet with epilepsy and behaviour in children
In a British study in 1989,
63 children with epilepsy tried the Few Foods diet. Most of the children (45)
had epilepsy with migraine or hyperactivity or both, and 18 had epilepsy alone.
Of the 45 with other symptoms of food intolerance, 75% per cent improved - 50%
ceased to have seizures and 25% had fewer seizures. Hyperactive behaviour
improved in all those who ceased to have seizures and some of those whose
seizures did not improve. None of the 18 who had epilepsy alone improved (Egger
and others, 1989).
The ketogenic diet with epilepsy and behaviour in children
The ketogenic (low carb) diet
has been used since the 1920s for children with difficult-to-control epilepsy,
and it has long been known that on this diet, children’s behaviour as well as
epilepsy improves. In a study using the ketogenic diet at
The ketogenic diet in rats
Medical experts do not know
why the ketogenic diet helps with difficult-to-control seizures, nor why
behavioural symptoms in epileptic children improve when children go on the
ketogenic diet for their epileptic symptoms, although the behavioural
improvement seems to be unrelated to seizure control. In an experiment using
two different types of ketogenic diets with rats, researchers found that, for
unknown reasons, both groups of rats showed a significantly lower activity
level than the rats on the control diet and suggested that this behavioral
change may relate to the improved behaviour seen when children with symptoms of
ADHD are placed on the ketogenic diet (Murphy and others, 2005).
A long term follow up of 150
children who had used the ketogenic diet for less than a year found that
whether or not the diet was effective, most families did not regret trying it
and would recommend it to others (Marsh and others, 2006).
The ketogenic diet in practice
In Australia, many children
on the ketogenic diet eventually switch to failsafe eating for behaviour
control after they are able to come off their epilepsy medication, see the
kuekids website below.
Food chemicals associated with seizures
Foods and food chemicals that
have been associated with seizures include artificial colours, preservatives,
MSG, salicylate-containing foods and drugs, amine containing foods and cow’s
milk.
From the failsafe point of
view, the ketogenic or low carb diet restricts high carbohydrate foods such as
bread, cakes, hamburgers, donuts and snack foods that are likely to contain
nasty food additives. It also restricts salicylates because it forbids fruit
juice, fruit and many vegetables. This could be why researchers who use the
ketogenic diet with epileptic children have observed positive changes in
seizures and behaviour as well.
Medications for epilepsy are
a major problem for epileptics who would like to try failsafe eating because
medications for epilepsy generally contain artificial colours that have been
found to be associated with both seizures and behavioural problems. Medications
may also be a problem with the ketogenic diet due to high carbohydrates in
sugar syrups and other sweeteners (McGhee and others, 2001).
Reader’s stories
[434] My daughter’s epilepsy (August 2006)
My daughter is 7 years old.
She has development delay, autism and was diagnosed with Lennox Gastaut
Syndrome at the age of two. She began the
ketogenic diet in 2000 and
stayed on it for three years and three months.
My daughter became seizure
free after 14 months on the ketogenic diet - it took nine months to wean her
off all the drugs and another five months to take out all the foods that were
causing her problems. I found the diet very difficult as I didn't have enough
medical backup to see me through it. A mum from the kuekids list was my only
support and I would not have done it without her.
I was so tired and felt so sorry
for my daughter being on such a restricted diet and yet still having seizures
but I had to see if the diet actually worked on its own. Her last seizures were
all occurring during her sleep and I thought "at least she's not hurting
herself" but I was forever running into her bedroom to help her get
through her seizures. I was so frightened that I had done the wrong thing,
weaning her off of all her drugs and the seizures were not getting any better.
Three months before my
daughter became seizure free, I was lucky to find a paediatrician who believed
in what I was doing. She actually advised me not to reintroduce the drugs. The
best thing I ever did was getting rid of the drugs altogether because I was
then able to fine tune.
What I did find, however, was
that whatever my daughter ate really affected her. Two days before she became
seizure free I removed carrots from her diet because that was the only food I
was giving her in the last meal that wasn't failsafe and a miracle happened.
The following night she had a cluster of 20 very slight myoclonics and that
cluster was the last seizure she ever had (April, 2001). She has been off the
keto diet since July 2003, however she remains failsafe and dairy free. I have
since tried her on carrots and found her to be having staring sessions (were
they absence seizures?) and keep her off of foods with beta-carotene.
It's paid off in the long
run. She is talking, doing well at school, playing with other children, enjoys
her food (although I still have her on a mild diet watching what she eats) and
is generally happy 100 per cent of the time. I don't know what I would have
done without the ketogenic diet and failsafe foods.
Note: a medically sypervised ketogenic diet is
available through the Children’s Epilepsy Program at Royal Children’s Hospital
in
[565] One-liners (May 2007)
I took my 4-year-old daughter off all additives, preservatives and
colours. In one week she has had a dramatic reduction of mostly myoclonic type
seizures, down from her usual 2 - 40 throughout each day before" – Karen.
Further reading - abstracts of all papers mentioned
below can be found at www.pubmed.com
Egger J, Carter CM, Soothill
JF, Wilson J. Oligoantigenic diet treatment of children with epilepsy and
migraine. J Pediatr 1989;114(1):51-8.
Lefevre F, Aronson N.
Ketogenic diet for the treatment of refractory epilepsy in children: A
systematic review of efficacy. Pediatrics 2000;105(4):E46. (free full text at www.pubmed.com)
MacCracken KA, Scalisi JC.
Development and evaluation of a ketogenic diet program. J Am Diet Assoc
1999;99(12):1554-8.
Marsh EB, Freeman JM, Kossoff
EH, Vining EP, Rubenstein JE, Pyzik PL, et al. The outcome of children with
intractable seizures: a 3- to 6-year follow-up of 67 children who remained on
the ketogenic diet less than one year. Epilepsia 2006;47(2):425-30.
McGhee B, Katyal N. Avoid
unnecessary drug-related carbohydrates for patients consuming the ketogenic
diet. J Am Diet Assoc 2001;101(1):87-101.
Murphy P, Likhodii SS,
Hatamian M, McIntyre Burnham W. Effect of the ketogenic diet on the activity
level of Wistar rats. Pediatr Res 2005;57(3):353-7.
Najbauer J, Schuman EM,
Mamelak AN. The aspirin metabolite sodium salicylate causes focal cerebral
hemorrhage and cell death in rats with kainic acid-induced seizures.
Neuroscience 2000;99(1):107-17.
Nemeroff CB, Crisley FD.
Monosodium L-glutamate-induced convulsions: temporary alteration in blood-brain
barrier permeability to plasma proteins. Environ Physiol Biochem
1975;5(6):389-95.
Nordli DR, Jr., Kuroda MM,
Carroll J, Koenigsberger DY, Hirsch LJ, Bruner HJ, et al. Experience with the
ketogenic diet in infants. Pediatrics 2001;108(1):129-33.
Schubert TA.
Salicylate-induced seizures in a dog. J Am Vet Med Assoc 1984;185(9):1000-1.
Australian support website for children with
difficult-to-control epilepsy using the ketogenic diet and/or progressing to
failsafe eating: http://home.primus.com.au/kuekids/home/
The information given is not intended as
medical advice. Always consult with your doctor for underlying illness. Before
beginning dietary investigation, consult a dietician with an interest in food
intolerance. You can find a supportive dietitian through the Dietitians
Association of
© Sue Dengate update September 2006
