Date:  
   
2004-10-20
   
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Mayo Clinic Finds Ketogenic Diet May Be Started As An Outpatient Treatment For
Children With Epilepsy

ROCHESTER, Minn. -- Results from a Mayo Clinic study that analyzed medical
records of epilepsy patients suggest a ketogenic diet, which mimics the effects
of starvation, can be successfully implemented with children on an outpatient
basis.
   
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The study, which appeared in the September issue of Pediatric Neurology, offers
data that compared inpatient (treating and staying in the hospital) and
outpatient (treating and then returning home) treatments using a ketogenic
diet. The researchers said the benefits of outpatient treatment include
improved acceptability and ability to maintain and comply with the diet. It
also avoids the expense, inconvenience and potential low blood sugar associated
with starvation during inpatient initiation. However, the intense educational
process that inpatients receive could be preferable for some families and
centers.

“Our study shows that it’s possible to begin the diet safely as an
outpatient and maintain it without restricting fluids as done in other
centers,” says Jeffrey Buchhalter, M.D., of the Pediatric Epilepsy Program in
the Department of Neurology at Mayo Clinic and the senior author of the study.
“For parents with children who have epilepsy, it means potentially fewer days
of lost work while the diet is initiated and more comfort for their child.
However, we do recommend that these findings need to be confirmed in a
prospective study.”

The Mayo Clinic authors of the study say further study is needed for more
definitive answers about the best conditions for implementing and maintaining
of the ketogenic diet.

Different diets have been popular in the treatment of epilepsy since ancient
times. In the 5th century B.C., Hippocrates reports about a man suffering from
epilepsy completely cured by abstinence from food and drink. The ketogenic
diet, which is very high in fats and low in carbohydrates, was first developed
almost 80 years ago. It makes the body burn fat for energy instead of glucose.
The diet mimics the effects of starvation. When carefully monitored by a
medical team familiar with its use, the diet helps two out of three epileptic
children and may prevent seizures in one out of three, according to the
Epilepsy Foundation. The diet has to be rigidly controlled. Any deviation can
produce a seizure if the patient is thrown out of ketosis, a presence in the
blood of abnormally high levels of acidic substances.

In the study, Mayo Clinic researchers used the Rochester Epidemiology Project
medical records-linkage system to locate all diagnoses involving the ketogenic
diet from 1963-1975. The system index allows the identification of all medical
visits of residents of Olmsted County, Minn., including inpatient, outpatient
and emergency department evaluations since 1935. In the study, records were
reviewed of 37 patients who underwent the ketogenic diet as outpatients and 17
as inpatients.

There was no evidence that inpatient initiation of the ketogenic diet was
superior to outpatient initiation with regard to long-term seizure control or
mental improvement. This improvement rate was similar to the range of other
reported studies.

In the Mayo Clinic study, there were no statistical differences in outcome
between the groups started as inpatients and outpatients.

Editor's Note: The original news release can be found here.
sciencedaily.com