A ketogenic diet could help to treat severe drug-resistant epilepsy in babies, a study has revealed.
Researchers at Great Ormond Street Hospital (GOSH) compared the effects of a ketogenic diet to anti-seizure medication for infants aged one to 24 months with drug-resistant epilepsy.
They found that the diet was just as effective as medication in reducing the frequency of seizures, and made no significant difference to quality of life.
The ketogenic diet, better known as the "keto" diet, involves eating low amounts of carbohydrates but high amounts of healthy fats and protein.
Scientists believe the diet is particularly effective as it mimics the effects of fasting, which has been found to reduce seizures in patients. The diet induces a process called ketosis, in which the body burns fat for energy instead of glucose.
Epilepsy is considered drug-resistant when two anti-epileptic drugs have failed to control a patient's seizures. The condition affects around one third of epilepsy sufferers, according to the Epilepsy Society.
The study is the first of its kind to directly compare the effects of a ketogenic diet to anti-seizure medication in babies.
Lead author and GOSH dietician, Dr Natasha Schoeler, said: “We can’t overpromise and say that a ketogenic diet is better than another drug. However, it should be considered as another treatment option.”
She added: "The diet is very strict and all recipes are made by dietitians. This means that everything must be weighed out properly. However, there are also prescribable products that some infants can eat too – so it is palatable.
“It depends on the family, but it is generally easier for children to start the diet when they are young."
A study published in 2021 by the UCL Queen Square Institute of Neurology found that the ketogenic diet could reduce the frequency of seizures in children and adults.
Researchers found that an oral liquid supplement based on the diet led to a mean 50 per cent reduction in seizures or paroxysmal events over a 12-week period.
However, experts have warned that the keto diet may not be suitable for everyone as it can cause constipation, low blood sugar and stomach problems.
‘The change was incredible’
Ace, 10, began suffering from partial epilepsy seizures aged just 14 weeks old. At 5 months she developed infantile spasms - a severe type of epilepsy that usually occurs under the age of two years which causes stiffening of the body and jerky movements of the head, arms or legs.
It took a further seven months for her to be diagnosed with a SCN8A gene mutation - a condition that causes developmental delays and learning difficulties, as well as also being a common cause of drug-resistant epilepsy in children.
Steroids failed to control her seizures and she was started on a new anti-epilepsy drug called vigabatrin - but this failed to stop her seizures and caused fatigue. She was later put on the ketogenic diet plan at GOSH.
Her mum Rai said: “Before the ketogenic diet, Ace was seizing daily but within a few months the change in her was incredible.”
“Quite quickly we also saw her interest in her surroundings improving and she’d start kicking toys in her pram, looking in mirrors, rolling on the floor – all the developmental milestones that weren’t there before. Her daily seizures had reduced to a mild seizure occurring about once a month.
“When Ace was eight we decided to remove the ketogenic diet and she has been having normal foods since, and has been stable. In fact, for the past few months she hasn’t had any seizures.”
She added: “We’ve been mind-blown by how lucky we’ve been with Ace – I know it may not benefit all patients but the ketogenic diet has really improved our daughter’s quality of life.”
“I hope that other families who want to access the diet for their children with drug-resistant epilepsy are able to.”
