29 June 2017
Specialised diet helps children suffering from epileptic seizures
Ketogenic dietitians at Bristol Royal Hospital for Children are
helping young people with epilepsy manage their seizures through a
specialised diet.
The ketogenic diet is high in fat, with low amounts of
carbohydrate and sufficient protein for growth. Each diet is
tailored to an individual's needs and can be given orally or
through a feeding tube.
The team treats patients from birth to 18 years old in the South
West and also accepts referrals from across the UK, including a
recent expansion of the service to South Wales.
When eating a normal diet our brain uses glucose as its main
source of fuel, which comes from carbohydrates. When these foods
are removed from the diet and replaced with a diet very high in
fat, the body responds by producing ketones, which the brain starts
to use as its new fuel.
The exact mechanism of how the diet works isn't yet known
however it appears to reduce the abnormal electrical activity in
the brain which can cause seizures. This may be due to the direct
action of the ketones produced or the metabolic changes associated
with ketosis.
The service was set up in 2010 and has since treated more than
90 patients and continues to grow, with more neurologists
considering this as a robust treatment option for the management of
epilepsy.
Victoria Bittle, specialist paediatric ketogenic dietitian
said:
"We have found the diet to be effective in lots of different
types of seizure disorders and infantile spasms.
"Fasting has been used as a treatment for seizures for many
years and was first used in the 1920's as a treatment for
epilepsy.
"Generally, a third of patients respond very well, 10-20%
becoming seizure free. A third have a 50% improvement and a third
unfortunately don't respond at all. In some cases, it may be
possible to reduce or even stop anti-epileptic medications, a
decision made by the neurologist.
"A three month trial is offered to all patients to assess the
effectiveness of the diet and we only continue with it if there has
been a marked improvement in the child's quality of life.
"Children should be considered for the diet if they have failed
to respond to two or more anti-epileptic medications. A paediatric
neurologist or consultant paediatrician can refer to us.
"The ketogenic diet can be administered orally or through a
feeding tube and can be used in combination with medications and
other therapies.
"It's so rewarding to be able to help children through the diet
and see the incredible life changing effects it can have."
Mandy Savin's little boy, Jack, experienced a seizure at 18
months old which led to him being hospitalised. It was discovered
he had a rare genetic disorder known as SCN2A. After trying
different medication, consultants suggested that they begin a
ketogenic diet to help reduce Jack's seizures:
"I had done some reading about it and thought it sounded great,
but didn't realise they offered it in the UK, so I was thrilled
when we got referred over to the team in Bristol.
"They were fantastic they
ran some tests on him to make sure he was going to be ok on it and
we started it in February 2016.
"A few weeks later he
picked up a bug and we got sent back to hospital with terrible
seizures, but we weren't deterred and continued with the diet.
"We started noticing some
real cognitive changes in him - a few smiles started shining
through, something we hadn't seen in nearly six months. We were so
excited and the seizures where becoming less and less.
"From then on he has just
gone from strength to strength; he has gone from having up to 50
seizures a day to on average one or two a week.
"It's amazing how well he
is doing, he's gone from being tube fed to feeding himself with a
bottle; he is crawling around the room and even looking to play
with his toys and again; and best of all he's laughing with his
little sister.
"We are so grateful to the
staff in Bath and Bristol for never giving up on our little boy and
always fighting for him."
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