The ketogenic diet is used as a method for treating
seizures and has been recommended for certain mitochondrial/metabolic disorders.
The ketogenic diet is used when a child's seizures have not been satisfactorily
controlled with adequate trials of medications or when a child has experienced
undesirable effects from the various seizure drugs. An important requirement for
beginning the diet is a commitment from those who will be taking care of the
child, as the diet requires extra time and effort.
The word "ketogenic" refers to ketone bodies that
are products of fat breakdown. The ketogenic diet is specifically planned to
meet all of your child's caloric requirements for growth and development, but it
does contain excess fat and it contains only limited carbohydrate and protein.
The diet works by changing how the brain obtains its energy to function. Instead
of getting energy from sugar, the brain will get energy from fat. Precisely how
this helps to control seizures is not known.
The ketogenic diet is not new. It has been
effectively used for many years and has decreased the frequency of seizures in
thousands of patients. Prior to beginning the diet, we will request that you
become as familiar as possible with the rationale for using the diet. It is
essential that you learn what will be required in planning and preparing the
diet. In addition, you should be aware of the possible side effects of the diet.
You will be meeting with the ketogenic diet team
during the hospital admission and frequently while your child is on the diet.
The team consists of a neurologist, a registered nurse (ketogenic diet
coordinator), and a registered dietitian. Meal plans will be provided before you
leave the hospital. Should problems arise while you are at home, the ketogenic
diet team will be available to answer your questions.
Once your child is admitted to the hospital,
he/she will initially receive only limited amounts of water or sugar-free
liquids until he/she begins to show ketone bodies in the urine. Do not allow
your child to eat or drink anything else. Usually within 24 hours of admission
to the hospital your child will begin the ketogenic diet. The diet contains a
fixed amount of calories, carbohydrate, fat, and protein. Your child will also
need extra calcium, vitamin D, iron and other vitamins, and these will be
provided in your diet plan. Most children accept the diet unexpectedly well. On
occasion your child may become sleepy, may vomit, or may refuse the first few
meals. These are usually only short-term problems.