NYM Offers A Special Diet for Children with Epilepsy

Date: April 6, 2006

Title: NYM Offers A Special Diet for Children with Epilepsy

Health Topic: Pediatrics

New York Methodist Hospital is the only hospital in Brooklyn to offer the ketogenic diet, a specialized treatment to help reduce seizures in children who do not respond to medication alone. "The ketogenic diet was created in the 1920s but with the development of anticonvulsant medications, it was gradually forgotten," said Romaine Schubert, M.D., chief of pediatric neurology at NYM. "However, because some children do not respond to these medications, the ketogenic diet was reintroduced in the late 1990s and is now achieving widespread usage," she said. Similar to the Atkins diet, the ketogenic diet is a carefully calculated meal plan that is high in fat and very low in carbohydrates. "Based on biblical stories, the ketogenic diet is a deliberate attempt to replicate the fasting state," said Dr. Schubert. "With the ketogenic diet, eating foods that are high in fat and very low in carbohydrates and proteins causes an increased blood level of chemicals called ketones, which reduce seizures," she said.

Although the diet has some similarities to the Atkins diet, the ketogenic diet is stricter. ìThe parent has to be very motivated and exact; it truly is an all or nothing diet," said Dr. Schubert. "Coming off the diet even for one day can start the seizures again," she said. Because of this, the demanding diet must be initiated under careful supervision of both physicians and dieticians. At NYM, Dr. Schubert works closely with dietician Diane Giammarino, R.D., to ensure that the child''s family is properly trained for successful maintenance. Items such as condiments and even toothpaste can alter the diet''s results. "The diet is extremely precise," said Ms. Giammarino. "For an infant, each day the parent needs to combine a specific amount of carbohydrate-free baby formula, carbohydrate powder and oil," she said. As the child grows, the diet must be continually adjusted to ensure that the child is receiving adequate nutrition. "Every month, we meet with the parents and child to recalculate the formula based on factors such as weight and blood levels," said Ms. Giammarino.

Although the diet is challenging for both the child and parent, the outcome can be very rewarding. "Within days of being on the diet, the child may have a dramatic drop in seizure rates and after two or three years, the seizures stop and the diet is no longer necessary," said Ms. Giammarino. "It is so exciting to see a child doing well after having tried numerous ineffective treatments," she said. Dr. Schubert agrees. "The diet has worked extremely well, patients report feeling more alert and have significantly fewer or no seizures."

For more information on the ketogenic diet, please contact New York Methodist Hospitalís division of pediatric neurology at (718) 780-5267.

Romaine Schubert, M.D., chief of pediatric neurology at NYM, began offering the ketogenic diet as an alternative treatment for children with difficult-to-control epilepsy.