Place Your Advertisement Here. All ad revenues support the mission of the Epilepsy Therapy Project.
 

Welcome to the redesigned epilepsy.com

It is now easier and faster than ever to access news, articles and community content. With less clutter and an improved navigation system, your favorite content is now only a click away.

The new features include:

  • Streamlined design with less clutter to promote important content and sections
  • New slider masthead
  • New horizontal menu across the site to ease top level navigation
  • Re-designed content pages that are easier to navigate
  • Overall new, fresh look!

Place Your Advertisement Here

Take control of your epilepsy and seizures. Seizure management has never been easier.

TAKE CONTROL TODAY

Sign up for our Newsletter!



Does Ketosis Matter? Discussion at the 2008 American Epilepsy Society

By Eric Kossoff, MD
Editor, Keto News

AES

Every December, the ketogenic diet research community gathers at the annual meeting of the American Epilepsy Society (AES) to discuss topics related to the ketogenic diet. At this “SIG” (special interest group), which I have coordinated since 2007, approximately 150 attendees will typically present new material, openly disagree, and debate more controversial topics. The AES SIGs are less regulated (and no continuing medical education credit is provided), hence often a more interactive and exciting setting than typical AES sessions. Attendees include neurologists, basic scientists, and dietitians.

This year’s ketogenic diet SIG in Seattle was no exception: a controversial topic was discussed and a lively debate ensued. This year, we had the issue of “Does ketosis really matter?” discussed from three perspectives: a basic science, clinical neurology, and dietitian perspective.

After I gave a brief introduction to the topic, Dr. Mac Burnham from University of Toronto presented his research regarding acetone as an anticonvulsant. He believed that the data does support that ketosis is important for seizure control in animal models, but interestingly not serum beta-hydroxybutyrate (BOH), which is often measured in clinical studies and occasionally by parents. He believed that acetone was the most important ketone in regards to seizure control. There was some disagreement voiced from basic scientists interested in caloric restriction and glucose modulation (as other mechanisms of action for the ketogenic diet) after his presentation.

Next, Dr. Elaine Wirrell from Mayo Clinic in Rochester, Minnesota gave a lecture on whether ketosis matters from a neurologist’s perspective. At this time, only one study by Dr. Gilbert in 2000, reported that higher levels of serum BOH correlated with improved seizure control (and were possibly more accurate than urine ketone measurement). This study, however, has never been replicated or confirmed. She highlighted that the low glycemic index treatment (See May 2007 Keto News) does not lead to significant ketosis, and yet still preliminarily leads to seizure control. Lastly, Dr. Wirrell discussed recent studies, including those on the modified Atkins diet, that ketosis does seem important during the first month…but not afterwards. This evidence seems to suggest that ketosis may be a marker of the metabolic state while on the ketogenic diet (and possibly correlates with early compliance and success), but does not clearly correlate with seizure control.

Lastly, Dr. Liz Neal from the Institute for Child Health in London, travelled across the Atlantic Ocean to present the dietitians’ perspective on this difficult topic. Dr. Neal discussed data from the recently completed randomized controlled trial of the ketogenic diet (See June 2008 Keto News). In this study, the classic (long-chain) triglyceride ketogenic diet led to higher levels of serum ketones at several time points when compared to the medium chain triglyceride (MCT) diet. However, this did not correlate with seizure control and both diets were equivalent. Interesting additional information regarding carnitine and the general lack of correlation with efficacy in her experience was also discussed.

In summary, I think the jury is still out on the role of ketosis in the ketogenic diet. Most basic scientists today believe that it is not the only (or even primary) mechanism of action of dietary therapy (See October 2007 Keto News). As was clear from both Drs. Wirrell and Neal, both child neurologists and dietitians are starting to agree. However, ketosis may be important during the initial several months based on some clinical research.

Topic Editor: Robert Fisher, MD, PhD
Last Reviewed: 1/30/09


Welcome to the Wiki. This space is created for epilepsy.com members to share their own experiences and expertise to help refine and expand the discussion around important topics.

No members have yet contributed to this topic. If you are not yet an epilepsy.com member, register today to get started on this Wiki topic and the many other advantages of being a member. If you are a member and wish to be the first to edit this Wiki topic, please make sure to login, then click on the orange "Start Wiki" button at the top of this page. Or, learn more about Wikis.



Place Your Advertisement Here

Title Posted
I'm not getting any better; this sucks. (And hello.)  
57Academics
How long before Keppra (Levetiracetam) leaves blood stream?  
eviesmumma2030
Meds and sex drive  
colamaid09
Reduction in Keppra  
happygirl
Epilepsy or brain tumor?  
aj85
Surgery for a fairly well controlled condition?  
nick714754
Daughter just diagnosed  
lamauld
Do Aus and Abu Dhabi have many special rules regarding drugs  
maticusw
benign rolandic epilepsy  
jdw1343
benign rolandic epilepsy  
jdw1343
View all Forums

Title Page Views
my.epilepsy.com Updates  
epi_help
topamax and weight loss  
alexia mom
kepra  
brian mattingly
Possible cure for absence seizures  
pdl1
How exactly do aura's feel  
WendyBendy
Sexual Side Effects  
George R
MEDICAL ALERT I.D.'s  
picnupthepcs
Over 40 Different Types Of Seizures - Revised  
spiz
electrical shock in head?  
Maggie
Weight Gain and Depakote  
galinda
View all Forums

Title Posted
marijuana  
ccraven
My walk towards surgery  
pfincher
Surgery To Eliminate Epilepsy  
xyz123dpzlis
the life of a Keto mom  
andersonboys3
frequent hot flashes??? at age 25???  
2spacey4me
Today driving  
empery521
My First Seizure  
xyz123dpzlis
my partial complex seizures  
Zanna1211
Getting help that all we need,  
eblack1277
Maybe it's not so nocturnal? (mind purge and whine fest)  
confuzzed
View all Blogs

Title Page Views
my partial complex seizures  
Zanna1211
Topomax... The Dreaded.........  
Dr Jason
Brain Zaps, tics & twitches  
JudiS
How can you tell if a sleep seizure happens?  
epl_controller
Feeling Sick  
JBJ1984
side effects of phenobarb.  
pksmom
Tegretol XR and ANXIETY meds  
Butterflygrl
TYLENOL, AEDs & SEIZURES  
cmscribbles
Nonepileptic "Events" vs. "Seizures"  
teft
newborn seizure  
Sunny_80
View all Blogs

Title Posted
Diving with eplilepsy  
p59
Moms of epileptic toddlers  
Xaviersmom2
Autism  
Aaron Chan
brain surgery  
jen020309
People in their 20's with epilepsy  
Mandy911
TEAM ETP  
krisj
24yr old male  
Dave24
Could I be Epileptic  
kathygardendancer
Lamotrogine....Severe feelings of detachment, with fear of dying or going insane?  
DazzlinDessie
epileptics with a new vns implant so a new lease on life  
bsloan1
View all Groups

Title Posted
Hello. I'm new to the forum  
Tom S.
Maxx  
MDS2006
Lyme Disease as a cause for seizures  
ssidah
new member  
cricketsgidget
Living with photo-sensitive seizures  
photo-sense_grl
My mom with what I think is partial complex seizures  
rckout1205
Hi New Here and really, really need help. Please!  
mlmetkit
Scared and Worried  
Ashleyy
My Story- Partial Complex Seizures  
w_mirandacruz
My Teenage Daughter was Just Diagnosed With JME  
simon48183
View all Stories