Dietary Treatment of Epilepsy

Epilepsy is a common chronic neurological disorder characterised
by recurrent unprovoked seizures, and affects 50 million people
worldwide. Approximately 30% of these do not have seizure control
even with the best available medications, hence renewed and
increasing interest in the use of dietary treatments to treat
epilepsy. These treatments include the traditional ketogenic diets
but also the newer modified Atkins diet and low glycaemic index
treatment.

The ketogenic diet is a high-fat, adequate-protein,
low-carbohydrate diet that in medicine is used primarily to treat
refractory epilepsy in children, and requires the dedicated support
of a multi-disciplinary team including doctors and
dietitians. Dietary Treatment of Epilepsy: Practical
Implementation of Ketogenic Therapy provides comprehensive and
practical training on all aspects of implementing and managing
dietary treatments for epilepsy, with key chapters on assessment,
calculations, implementation, monitoring and complications.

Edited by a highly respected expert in the field supported
by a strong team of contributors, this is a must-have resource for
paediatric dietitians and other members of the therapy team.

Auteur

Elizabeth Neal has both clinical and research experience
in the dietary treatment of epilepsy, with a PhD in ketogenic
diets. She is based at the Institute of Child Health in London, and
Matthew's Friends charity and clinics.

Résumé

Epilepsy is a common chronic neurological disorder characterised by recurrent unprovoked seizures, and affects 50 million people worldwide. Approximately 30% of these do not have seizure control even with the best available medications, hence renewed and increasing interest in the use of dietary treatments to treat epilepsy. These treatments include the traditional ketogenic diets but also the newer modified Atkins diet and low glycaemic index treatment.

The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat refractory epilepsy in children, and requires the dedicated support of a multi-disciplinary team including doctors and dietitians. Dietary Treatment of Epilepsy: Practical Implementation of Ketogenic Therapy provides comprehensive and practical training on all aspects of implementing and managing dietary treatments for epilepsy, with key chapters on assessment, calculations, implementation, monitoring and complications.

Edited by a highly respected expert in the field supported by a strong team of contributors, this is a must-have resource for paediatric dietitians and other members of the therapy team.

Contenu

Contributors vii

Foreword ix

A personal note x

Section 1 Introduction and Overview 1

1 Introduction to the ketogenic diet and other dietary
treatments 3

Elizabeth Neal

2 Epilepsy and epileptic seizures 11

J. Helen Cross

3 Treatment options in the paediatric epilepsy clinic 19

Ruth E. Williams

4 Efficacy of ketogenic dietary therapy: what is the evidence?
24

Eric H. Kossoff

5 The biochemical basis of dietary therapies for neurological
disorders 34

Adam L. Hartman and Jong M. Rho

Section 2 Clinical Implementation 45

6 Preparing for dietary treatment 47

Georgiana Fitzsimmons

7 The challenge of therapeutic diets in children with
pre-existing feeding problems 58

Bridget Lambert and Mary-Anne Leung

8 The classical ketogenic diet 66

Gwyneth Magrath and Elizabeth Neal

9 The medium-chain triglyceride ketogenic diet 78

Elizabeth Neal

10 The modified Atkins diet 89

Gwyneth Magrath, Mary-Anne Leung and Tara Randall

11 The Low Glycaemic Index Treatment 100

Heidi H. Pfeifer

12 Managing dietary treatment: further dietetic issues 109

Jan Chapple

13 Managing dietary treatment: a parent's perspective
116

Emma Williams

14 Enteral feeding 124

Jan Chapple

15 Dietary initiation 131

Jan Chapple

16 Ketone monitoring and management of illness 135

Hannah Chaffe

17 Fine tuning 142

Gwyneth Magrath

18 Monitoring and side effects 149

Elizabeth Neal

19 Dietary treatments and bone health 159

Christina Bergqvist

20 Carnitine 166

Elizabeth Neal

21 Switching or discontinuing dietary treatment 172

Bridget Lambert

Section 3 Broader Applications 179

22 Dietary treatment of epilepsy in infants 181

Nicole Dos Santos

23 Dietary treatment of epilepsy in adults 189

Susan Wood

24 Ketogenic dietary therapy in India 198

Janak Nathan

25 Ketogenic dietary therapy in East Asia 206

Hoon-Chul Kang and Heung Dong Kim

26 Ketogenic dietary therapy in Africa 215

Tuscha Du Toit

27 Ketogenic dietary therapy in neurometabolic disease 220

Joerg Klepper

28 Beyond epilepsy: ketogenic diet use in other disease states
225

Adam L. Hartman and Jong M. Rho

Afterword 232

Appendix 234

Index 235