FOOD INTOLERANCE NETWORK FACTSHEET
Epilepsy, diet and behaviour
Epilepsy in children and adults is frequently associated
with ADHD-type behavioural symptoms. Trials of both the Few Foods and the
ketogenic low carbohydrate diet have found that symptoms of both behaviour and
epilepsy can improve on restricted diets although epilepsy without behaviour
problems is unlikely to improve.
The Few Foods diet
with epilepsy and behaviour in children
In a British study in 1989, 63 children with epilepsy tried the
Few Foods diet. Most of the children (45) had epilepsy with migraine or
hyperactivity or both, and 18 had epilepsy alone. Of the 45 with other symptoms
of food intolerance, 75% per cent improved - 50% ceased to have seizures and
25% had fewer seizures. Hyperactive behaviour improved in all those who ceased
to have seizures and some of those whose seizures did not improve. None of the
18 who had epilepsy alone improved (Egger and others, 1989).
The ketogenic diet
with epilepsy and behaviour in children
The ketogenic (low carb) diet has been used since the 1920s
for children with difficult-to-control epilepsy, and it has long been known
that on this diet, children’s behaviour as well as epilepsy improves. In a
study using the ketogenic diet at
The ketogenic diet in
rats
Medical experts do not know why the ketogenic diet helps
with difficult-to-control seizures, nor why behavioural symptoms in epileptic
children improve when children go on the ketogenic diet for their epileptic
symptoms, although the behavioural improvement seems to be unrelated to seizure
control. In an experiment using two different types of ketogenic diets with
rats, researchers found that, for unknown reasons, both groups of rats showed a
significantly lower activity level than the rats on the control diet and
suggested that this behavioral change may relate to the improved behaviour seen
when children with symptoms of ADHD are placed on the ketogenic diet (Murphy
and others, 2005).
A long term follow up of 150 children who had used the
ketogenic diet for less than a year found that whether or not the diet was
effective, most families did not regret trying it and would recommend it to
others (Marsh and others, 2006).
The ketogenic diet in
practice
In Australia, many children on the ketogenic diet eventually
switch to failsafe eating for behaviour control after they are able to come off
their epilepsy medication, see the kuekids website below.
Food chemicals
associated with seizures
Foods and food chemicals that have been associated with
seizures include artificial colours, preservatives, MSG, salicylate-containing
foods and drugs, amine containing foods and cow’s milk.
From the failsafe point of view, the ketogenic or low carb
diet restricts high carbohydrate foods such as bread, cakes, hamburgers, donuts
and snack foods that are likely to contain nasty food additives. It also
restricts salicylates because it forbids fruit juice, fruit and many
vegetables. This could be why researchers who use the ketogenic diet with
epileptic children have observed positive changes in seizures and behaviour as
well.
Medications for epilepsy are a major problem for epileptics
who would like to try failsafe eating because medications for epilepsy
generally contain artificial colours that have been found to be associated with
both seizures and behavioural problems. Medications may also be a problem with
the ketogenic diet due to high carbohydrates in sugar syrups and other
sweeteners (McGhee and others, 2001).
Reader’s stories
[434] My daughter’s epilepsy
(August 2006)
My daughter is 7 years old. She has development delay,
autism and was diagnosed with Lennox Gastaut Syndrome at the age of two. She
began the
ketogenic diet in 2000 and stayed on it for three years and
three months.
My daughter became seizure free after 14 months on the
ketogenic diet - it took nine months to wean her off all the drugs and another
five months to take out all the foods that were causing her problems. I found
the diet very difficult as I didn't have enough medical backup to see me
through it. A mum from the kuekids list was my only support and I would not
have done it without her.
I was so tired and felt so sorry for my daughter being on
such a restricted diet and yet still having seizures but I had to see if the
diet actually worked on its own. Her last seizures were all occurring during
her sleep and I thought "at least she's not hurting herself" but I
was forever running into her bedroom to help her get through her seizures. I
was so frightened that I had done the wrong thing, weaning her off of all her
drugs and the seizures were not getting any better.
Three months before my daughter became seizure free, I was
lucky to find a paediatrician who believed in what I was doing. She actually
advised me not to reintroduce the drugs. The best thing I ever did was getting
rid of the drugs altogether because I was then able to fine tune.
What I did find, however, was that whatever my daughter ate
really affected her. Two days before she became seizure free I removed carrots
from her diet because that was the only food I was giving her in the last meal
that wasn't failsafe and a miracle happened. The following night she had a
cluster of 20 very slight myoclonics and that cluster was the last seizure she
ever had (April, 2001). She has been off the keto diet since July 2003, however
she remains failsafe and dairy free. I have since tried her on carrots and
found her to be having staring sessions (were they absence seizures?) and keep
her off of foods with beta-carotene.
It's paid off in the long run. She is talking, doing well at
school, playing with other children, enjoys her food (although I still have her
on a mild diet watching what she eats) and is generally happy 100 per cent of
the time. I don't know what I would have done without the ketogenic diet and
failsafe foods.
Note: a medically sypervised ketogenic
diet is available through the Children’s Epilepsy Program at Royal Children’s
Hospital in
[565] One-liners (May 2007)
I took my 4-year-old
daughter off all additives, preservatives and colours. In one week she has had a
dramatic reduction of mostly myoclonic type seizures, down from her usual 2 -
40 throughout each day before" – Karen.
Further reading - abstracts of all papers mentioned
below can be found at www.pubmed.com
Egger J, Carter CM, Soothill JF, Wilson J. Oligoantigenic
diet treatment of children with epilepsy and migraine. J Pediatr
1989;114(1):51-8.
Lefevre F, Aronson N. Ketogenic diet for the treatment of
refractory epilepsy in children: A systematic review of efficacy. Pediatrics
2000;105(4):E46. (free full text at www.pubmed.com)
MacCracken KA, Scalisi JC. Development and evaluation of a
ketogenic diet program. J Am Diet Assoc 1999;99(12):1554-8.
Marsh EB, Freeman JM, Kossoff EH, Vining EP, Rubenstein JE,
Pyzik PL, et al. The outcome of children with intractable seizures: a 3- to
6-year follow-up of 67 children who remained on the ketogenic diet less than
one year. Epilepsia 2006;47(2):425-30.
McGhee B, Katyal N. Avoid unnecessary drug-related
carbohydrates for patients consuming the ketogenic diet. J Am Diet Assoc
2001;101(1):87-101.
Murphy P, Likhodii SS, Hatamian M, McIntyre Burnham W.
Effect of the ketogenic diet on the activity level of Wistar rats. Pediatr Res
2005;57(3):353-7.
Najbauer J, Schuman EM, Mamelak AN. The aspirin metabolite
sodium salicylate causes focal cerebral hemorrhage and cell death in rats with
kainic acid-induced seizures. Neuroscience 2000;99(1):107-17.
Nemeroff CB, Crisley FD. Monosodium L-glutamate-induced
convulsions: temporary alteration in blood-brain barrier permeability to plasma
proteins. Environ Physiol Biochem 1975;5(6):389-95.
Nordli DR, Jr., Kuroda MM, Carroll J, Koenigsberger DY,
Hirsch LJ, Bruner HJ, et al. Experience with the ketogenic diet in infants.
Pediatrics 2001;108(1):129-33.
Schubert TA. Salicylate-induced seizures in a dog. J Am Vet
Med Assoc 1984;185(9):1000-1.
Australian support
website for
children with difficult-to-control epilepsy using the ketogenic diet and/or
progressing to failsafe eating: http://home.primus.com.au/kuekids/home/
The information given is not intended as medical advice. Always consult
with your doctor for underlying illness. Before beginning dietary
investigation, consult a dietician with an interest in food intolerance. You
can find a supportive dietitian through the Dietitians Association of
© Sue Dengate update September
2006
