Therapeutic Effects of Ketogenic Diet in the Treatment of Epilepsy
top of page
Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute
Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute

Journal of Health and Medical Sciences

ISSN 2622-7258

Screen Shot 2018-08-12 at 1.24.09 AM.png
Screen Shot 2018-08-12 at 1.24.02 AM.png
Screen Shot 2018-08-12 at 1.23.57 AM.png
Screen Shot 2018-08-12 at 1.23.52 AM.png
crossref
doi
open access

Published: 18 August 2020

Therapeutic Effects of Ketogenic Diet in the Treatment of Epilepsy

Rabeea Mubarak, Izma Raza, Aleena Khursheed, Maham Mushtaq, Birah Hanif, Ayesha Bint Majeed

The University of Lahore, Pakistan

journal of social and political sciences
pdf download

Download Full-Text Pdf

doi

10.31014/aior.1994.03.03.131

Pages: 358-369

Keywords: Ketogenic Diet, Ketogenic Diet Therapy, Epilepsy, Seizures, Ketone Bodies, Amino Acids

Abstract

Epilepsy is characterized by seizures due to abnormal discharge of nerve impulses from the brain. Antiepileptic drugs are used to counter these seizures. However, in some types and severities in epilepsy where seizures are resistant to drugs, ketogenic diet (high in fat and low in carbohydrates) is used. In this review beneficial effects of ketogenic diet have been explored in treating epilepsy. It is used as a standard treatment for refractory epilepsy and has showed positive effects in treating all types of epilepsy, in all ages, especially in children. These findings were supported by previous studies which proved that ketogenic diet optimized the therapeutic effects against epilepsy by decreasing the oxidative stress, neuronal damage and enhancing the function of mitochondria. However, the exact mechanism of ketogenic diet in the treatment of epilepsy is still unknown but it can be used as potential therapy for children. More researches are needed to conclude the same for adults.

References

  1. Acharya, M. M., Hattiangady, B., & Shetty, A. K. (2008). Progress in neuroprotective strategies for preventing epilepsy. Progress in neurobiology, 84(4), 363-404. https://doi.org/10.1016/j.pneurobio.2007.10.010

  2. Allen, B. G., Bhatia, S. K., Anderson, C. M., Eichenberger-Gilmore, J. M., Sibenaller, Z. A., Mapuskar, K. A., . . . Fath, M. A. (2014). Ketogenic diets as an adjuvant cancer therapy: History and potential mechanism. Redox biology, 2, 963-970. https://doi.org/10.1016/j.redox.2014.08.002

  3. Aragon, A. A., Schoenfeld, B. J., Wildman, R., Kleiner, S., VanDusseldorp, T., Taylor, L., . . . Kalman, D. S. (2017). International society of sports nutrition position stand: diets and body composition. Journal of the International Society of Sports Nutrition, 14(1), 16. https://doi.org/10.1186/s12970-017-0174-y

  4. Barañano, K. W., & Hartman, A. L. (2008). The ketogenic diet: uses in epilepsy and other neurologic illnesses. Current treatment options in neurology, 10(6), 410. https://doi.org/10.1007/s11940-008-0043-8

  5. Bough, K. J., Gudi, K., Han, F. T., Rathod, A. H., & Eagles, D. A. (2002). An anticonvulsant profile of the ketogenic diet in the rat. Epilepsy research, 50(3), 313-325. https://doi.org/10.1016/S0920-1211(02)00086-4

  6. Cardinali, S., Canafoglia, L., Bertoli, S., Franceschetti, S., Lanzi, G., Tagliabue, A., & Veggiotti, P. (2006). A pilot study of a ketogenic diet in patients with Lafora body disease. Epilepsy research, 69(2), 129-134. https://doi.org/10.1016/j.eplepsyres.2006.01.007

  7. Cervenka, M. C., & Kossoff, E. H. (2013). Dietary treatment of intractable epilepsy. CONTINUUM: Lifelong Learning in Neurology, 19(3), 756-766. https://doi.org/10.1212/01.CON.0000431396.23852.56

  8. Clanton, R. M., Wu, G., Akabani, G., & Aramayo, R. (2017). Control of seizures by ketogenic diet-induced modulation of metabolic pathways. Amino Acids, 49(1), 1-20. https://doi.org/10.1007/s00726-016-2336-7

  9. Coppola, G., Veggiotti, P., Cusmai, R., Bertoli, S., Cardinali, S., Dionisi-Vici, C., . . . Tagliabue, A. (2002). The ketogenic diet in children, adolescents and young adults with refractory epilepsy: an Italian multicentric experience. Epilepsy research, 48(3), 221-227. https://doi.org/10.1016/S0920-1211(01)00315-1

  10. D'Andrea-Meira, I., Krüger, L. T., Romão, T., Paiva, M. E., Pires do Prado, H. J., & da Conceição, P. O. (2019). Ketogenic diet and epilepsy: what we know so far. Frontiers in neuroscience, 13, 5. https://doi.org/10.3389/fnins.2019.00005

  11. Duncan, J. S., Sander, J. W., Sisodiya, S. M., & Walker, M. C. (2006). Adult epilepsy. The Lancet, 367(9516), 1087-1100. https://doi.org/10.1016/S0140-6736(06)68477-8

  12. El-Rashidy, O., El-Baz, F., El-Gendy, Y., Khalaf, R., Reda, D., & Saad, K. (2017). Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study. Metabolic brain disease, 32(6), 1935-1941. https://doi.org/10.1007/s11011-017-0088-z

  13. Elia, M., Klepper, J., Leiendecker, B., & Hartmann, H. (2017). Ketogenic diets in the treatment of epilepsy. Current pharmaceutical design, 23(37), 5691-5701. https://doi.org/10.2174/1381612823666170809101517

  14. Forsgren, L., Beghi, E., Oun, A., & Sillanpää, M. (2005). The epidemiology of epilepsy in Europe–a systematic review. European Journal of neurology, 12(4), 245-253. https://doi.org/10.1111/j.1468-1331.2004.00992.x

  15. Freeman, J., Veggiotti, P., Lanzi, G., Tagliabue, A., & Perucca, E. (2006). The ketogenic diet: from molecular mechanisms to clinical effects. Epilepsy Res, 68(2), 145-180. https://doi.org/10.1016/j.eplepsyres.2005.10.003

  16. Freeman, J. M., & Kossoff, E. H. (2010). Ketosis and the ketogenic diet, 2010: advances in treating epilepsy and other disorders. Advances in pediatrics, 57(1), 315-329. https://doi.org/10.1016/j.yapd.2010.08.003

  17. Gasior, M., Rogawski, M. A., & Hartman, A. L. (2006). Neuroprotective and disease-modifying effects of the ketogenic diet. Behavioural pharmacology, 17(5-6), 431. https://doi.org/10.1097/00008877-200609000-00009

  18. Guelpa, G. (1911). La lutte contre l'epiepsie par la desintoxication et par la reeducation alimentaire. Rev Ther Med Chir, 78, 8.

  19. Ismayilova, N., Leung, M.-A., Kumar, R., Smith, M., & Williams, R. E. (2018). Ketogenic diet therapy in infants less than two years of age for medically refractory epilepsy. Seizure, 57, 5-7. https://doi.org/10.1016/j.seizure.2018.02.014

  20. Janigro, D. (1999). Blood–brain barrier, ion homeostasis and epilepsy: possible implications towards the understanding of ketogenic diet mechanisms. Epilepsy research, 37(3), 223-232. https://doi.org/10.1016/S0920-1211(99)00074-1

  21. Kang, H. C., Chung, D. E., Kim, D. W., & Kim, H. D. (2004). Early‐and late‐onset complications of the ketogenic diet for intractable epilepsy. Epilepsia, 45(9), 1116-1123. https://doi.org/10.1111/j.0013-9580.2004.10004.x

  22. Kossoff, E. H., Zupec‐Kania, B. A., Amark, P. E., Ballaban‐Gil, K. R., Christina Bergqvist, A., Blackford, R., . . . Dahlin, M. G. (2009). Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia, 50(2), 304-317. https://doi.org/10.1111/j.1528-1167.2008.01765.x

  23. Lambrechts, D., de Kinderen, R., Vles, J., de Louw, A., Aldenkamp, A., & Majoie, H. (2017). A randomized controlled trial of the ketogenic diet in refractory childhood epilepsy. Acta Neurologica Scandinavica, 135(2), 231-239. https://doi.org/10.1111/ane.12592

  24. Levy, R. G., Cooper, P. N., Giri, P., & Weston, J. (2012). Ketogenic diet and other dietary treatments for epilepsy. Cochrane database of systematic reviews(3). https://doi.org/10.1002/14651858.CD001903.pub2

  25. Liu, H., Yang, Y., Wang, Y., Tang, H., Zhang, F., Zhang, Y., & Zhao, Y. (2018). Ketogenic diet for treatment of intractable epilepsy in adults: A meta‐analysis of observational studies. Epilepsia Open, 3(1), 9-17. https://doi.org/10.1002/epi4.12098

  26. Martin-McGill, K. J., Jenkinson, M. D., Smith, C. T., & Marson, A. G. (2017). The modified ketogenic diet for adults with refractory epilepsy: an evaluation of a set up service. Seizure, 52, 1-6. https://doi.org/10.1016/j.seizure.2017.08.013

  27. Martins, L. D., Terra, V. C., Nicoletti, C. F., Chiarello, P. G., Marchini, J. S., Sakamoto, A. C., & Nonino-Borges, C. B. (2012). Effect of the classic ketogenic diet on the treatment of refractory epileptic seizures. Revista de Nutrição, 25(5), 565-573. https://doi.org/10.1590/S1415-52732012000500002

  28. Masino, S. A., Li, T., Theofilas, P., Sandau, U. S., Ruskin, D. N., Fredholm, B. B., . . . Boison, D. (2011). A ketogenic diet suppresses seizures in mice through adenosine A 1 receptors. The Journal of clinical investigation, 121(7), 2679-2683. https://doi.org/10.1172/JCI57813

  29. Masino, S. A., & Rho, J. M. (2012). Mechanisms of ketogenic diet action Jasper's Basic Mechanisms of the Epilepsies [Internet]. 4th edition: National Center for Biotechnology Information (US). https://doi.org/10.1093/med/9780199746545.003.0078

  30. McDonald, T. J., & Cervenka, M. C. (2017). Ketogenic diets for adults with highly refractory epilepsy. Epilepsy currents, 17(6), 346-350. https://doi.org/10.5698/1535-7597.17.6.346

  31. McDonald, T. J., & Cervenka, M. C. (2018). Ketogenic diets for adult neurological disorders. Neurotherapeutics, 15(4), 1018-1031. https://doi.org/10.1007/s13311-018-0666-8

  32. MILLICHAP, J. G., JONES, J. D., & RUDIS, B. P. (1964). Mechanism of anticonvulsant action of ketogenic diet: studies in animals with experimental seizures and in children with petit mal epilepsy. American Journal of Diseases of Children, 107(6), 593-604. https://doi.org/10.1001/archpedi.1964.02080060595008

  33. Neal, E. G., Chaffe, H., Schwartz, R. H., Lawson, M. S., Edwards, N., Fitzsimmons, G., . . . Cross, J. H. (2008). The ketogenic diet for the treatment of childhood epilepsy: a randomised controlled trial. The Lancet Neurology, 7(6), 500-506. https://doi.org/10.1016/S1474-4422(08)70092-9

  34. Nei, M., Ngo, L., Sirven, J. I., & Sperling, M. R. (2014). Ketogenic diet in adolescents and adults with epilepsy. Seizure, 23(6), 439-442. https://doi.org/10.1016/j.seizure.2014.02.015

  35. Penfield, W., & Erickson, T. C. (1941). Epilepsy and cerebral localization. https://doi.org/10.1097/00000441-194203000-00021

  36. Prins, M. L., & Matsumoto, J. H. (2014). The collective therapeutic potential of cerebral ketone metabolism in traumatic brain injury. Journal of lipid research, 55(12), 2450-2457. https://doi.org/10.1194/jlr.R046706

  37. Rho, J. M. (2017). How does the ketogenic diet induce anti-seizure effects? Neuroscience letters, 637, 4-10. https://doi.org/10.1016/j.neulet.2015.07.034

  38. Sampaio, L. P. d. B. (2016). Ketogenic diet for epilepsy treatment. Arquivos de Neuro-psiquiatria, 74(10), 842-848. https://doi.org/10.1590/0004-282X20160116

  39. Sampaio, L. P. d. B., Takakura, C., & Manreza, M. L. G. d. (2017). The use of a formula-based ketogenic diet in children with refractory epilepsy. Arquivos de Neuro-psiquiatria, 75(4), 234-237. https://doi.org/10.1590/0004-282x20170028

  40. Schoeler, N. E., Wood, S., Aldridge, V., Sander, J. W., Cross, J. H., & Sisodiya, S. M. (2014). Ketogenic dietary therapies for adults with epilepsy: feasibility and classification of response. Epilepsy & Behavior, 37, 77-81. https://doi.org/10.1016/j.yebeh.2014.06.007

  41. Schuchmann, C. A., Nurko, I., Rasmussen, H., Roehl, K., Tangney, C., Send, S., . . . Balabanov, A. (2017). Impact of a modified ketogenic diet on seizure activity, biochemical markers, anthropometrics and gastrointestinal symptoms in adults with epilepsy. The FASEB Journal, 31(1_supplement), 150.151-150.151.

  42. Sirven, J., Whedon, B., Caplan, D., Liporace, J., Glosser, D., O'Dwyer, J., & Sperling, M. R. (1999). The ketogenic diet for intractable epilepsy in adults: preliminary results. Epilepsia, 40(12), 1721-1726. https://doi.org/10.1111/j.1528-1157.1999.tb01589.x

  43. Stenger, E., Schaeffer, M., Cances, C., Motte, J., Auvin, S., Ville, D., . . . de Saint-Martin, A. (2017). Efficacy of a ketogenic diet in resistant myoclono-astatic epilepsy: a French multicenter retrospective study. Epilepsy research, 131, 64-69. https://doi.org/10.1016/j.eplepsyres.2017.02.005

  44. Tefera, T. W., & Borges, K. (2017). Metabolic dysfunctions in amyotrophic lateral sclerosis pathogenesis and potential metabolic treatments. Frontiers in neuroscience, 10, 611. https://doi.org/10.3389/fnins.2016.00611

  45. Thammongkol, S., Vears, D. F., Bicknell‐Royle, J., Nation, J., Draffin, K., Stewart, K. G., . . . Mackay, M. T. (2012). Efficacy of the ketogenic diet: which epilepsies respond? Epilepsia, 53(3), e55-e59. https://doi.org/10.1111/j.1528-1167.2011.03394.x

  46. Thiele, E. A. (2003). Assessing the efficacy of antiepileptic treatments: the ketogenic diet. Epilepsia, 44, 26-29. https://doi.org/10.1046/j.1528-1157.44.s7.4.x

  47. Walczyk, T., & Wick, J. Y. (2017). The ketogenic diet: making a comeback. The Consultant Pharmacist®, 32(7), 388-396. https://doi.org/10.4140/TCP.n.2017.388

  48. Ye, F., Li, X.-J., Jiang, W.-L., Sun, H.-B., & Liu, J. (2015). Efficacy of and patient compliance with a ketogenic diet in adults with intractable epilepsy: a meta-analysis. Journal of Clinical Neurology, 11(1), 26-31. https://doi.org/10.3988/jcn.2015.11.1.26

  49. Zhang, Y., Xu, J., Zhang, K., Yang, W., & Li, B. (2018). The anticonvulsant effects of ketogenic diet on epileptic seizures and potential mechanisms. Current neuropharmacology, 16(1), 66-70. https://doi.org/10.2174/1570159X15666170517153509

  50. Zhao, Z., Lange, D. J., Voustianiouk, A., MacGrogan, D., Ho, L., Suh, J., . . . Pasinetti, G. M. (2006). A ketogenic diet as a potential novel therapeutic intervention in amyotrophic lateral sclerosis. BMC neuroscience, 7(1), 29. https://doi.org/10.1186/1471-2202-7-29

bottom of page