Children whose epilepsy does not respond to medicine often do benefit from a special diet in which carbohydrates are to a large extent replaced by fats. From 7 to 40 percent of these children are even seizure-free. Together with colleagues, pediatric dietitian Dorine van den Hurk of UMC Utrecht drew up guidelines for treating epilepsy using what is known as a “ketogenic diet.” She describes this in the latest issue of Uniek, University Medical Center (UMC) Utrecht’s Dutch-language magazine.
Currently, every year between forty and fifty children in the Netherlands are put on a ketogenic diet, and according to Van den Hurk, this number could be as high as a hundred. “It’s a matter of awareness,” she says. “Parents don’t know about the diet, and in many cases neither do the doctors.”
In this diet, the carbohydrates are largely replaced by fats. As a result, the body starts to make ketones, which are by-products formed by fatty acids. Ketones are the most important source of fuel for the brain and also inhibit epileptic seizures, although it is not yet understood how this mechanism works. There is a drop in the number of seizures in 40 to 90 percent of the children who are on such a ketogenic diet. From 7 to 40 percent of these children are even seizure-free.
The new guidelines emerged from the “Dutch Multidisciplinary Partnership for Ketogenic Diets” (in Dutch: Multidisciplinair Samenwerkingsverband Ketogeen Dieet Nederland), which was established in 2004 and is headed up by Prof. Onno van Nieuwenhuizen of UMC Utrecht. The organization brings together doctors, dietitians, and others involved in the treatment of epilepsy.
In the same issue of Uniek 1 2008 : pediatric traumatologist William Kramer argues in favor of making bike helmets compulsory for children, improving pharmacotherapy education to reduce the number of medication errors, and how surgeons use virtual surgery to practice operations. Uniek is available online at www.uniekmagazine.nl (in Dutch).