Special diet curbs children's seizures.

Neurologists and nutritionists at Columbia-Presbyterian Medical Center. New York, are using a diet that can control seizures in epileptic children who do not respond to, or can not tolerate, medication. The "ketogenic diet" was devised in the 1920s. following anecdotal reports that fasting cured epilepsy. Although found to be useful, it fell out of favor over the years with the advent of effective anti-seizure medications, notes Douglas Nordli, Jr., director of the Pediatric Epilepsy Program.

The diet, however, is making a comeback as a therapy for children with epilepsy who either do not respond to medical treatment or suffer intolerable side effects. It is estimated that approximately 15% of the nation's 375,000 young epileptics fall into this category.

To begin the ketogenic diet, the patient must fast for about a day and a half; only water and sugar-free beverages are allowed. The fast continues until the child shows the presence of ketones in the urine. Ketones are produced when the body taps its fat stores for energy. The diet then is started. Because each meal is high in fat and low in protein and carbohydrates, the body continues to burn fat for energy, sustaining the ketotic state.

The fast, as well as the first three days of the dietary intervention, must be conducted in the hospital. "We have to monitor the child's electrolytes, and ensure that he or she doesn't become too hypoglycemic," explains nutritionist Joanne Carroll. "We also use this time to design a customized diet for each patient and to teach parents how to prepare the different meals and how to monitor the urine for ketones."

Studies show that the ketogenic diet eliminates...