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The use of diet in the treatment of epilepsy

      Abstract

      Fasting and other dietary regimens have been used to treat epilepsy since biblical times. The ketogenic diet, which mimics the metabolism of fasting, was used by modern physicians to treat intractable epilepsy beginning in the 1920s. With the rising popularity of drug treatments however, the ketogenic diet lost its previous status and was used in only a handful of clinics for most of the 20th century. The diet regained widespread recognition as a viable treatment option beginning in 1992 due to the efforts of parent advocate groups. Despite challenges to implementation of the treatment, the ketogenic diet has significant potential as a powerful tool for fighting epilepsy.

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      References

        • Lennox W.G.
        • Lennox M.A.
        Epilepsy and related disorders. vol. 2. Little, Brown, Boston1960
      1. Hippocrates. The genuine work of Hippocrates; translated from the Greek by Francis Adams. Baltimore, Williams and Wilkins, 1939, 368–369

        • Temkin
        • Owsei
        The falling sickness: a history of epilepsy from the Greeks to the beginnings of modern neurology.
        2nd ed., rev. Johns Hopkins Univ. Press, Baltimore1945
      2. The Bible, King James version. St. Mark; 9:29

        • Bladin P.F.
        • Eadie M.J.
        A disease once sacred: a history of the medical understanding of epilepsy.
        John Libbey, Eastleigh, England2001
        • Guelpa G.
        • Marie A.
        A lutte contre l’epilepsie par la desintoxication et par la reeducation alimentaire.
        Rev Ther Med Chirurg. 1911; 78: 8-13
        • Lennox W.G.
        • Cobb S.
        Epilepsy.
        Williams & Wilkins, Baltimore1928
        • Geyelin H.R.
        Fasting as a method for treating epilepsy.
        Med Record. 1921; 99: 1037-1039
        • Conklin H.W.
        Cause and treatment of epilepsy.
        J Am Osteopathic Assoc. 1922; 26: 11-14
        • Gamble J.L.
        • Ross G.S.
        • Tisdall F.F.
        The metabolism of fixed base during fasting.
        J Biol Chem. 1923; 57: 633-695
        • Wilder R.M.
        • Winter M.D.
        The threshold of ketogenesis.
        J Biol Chem. 1922; 52: 393-401
        • Peterman M.G.
        The ketogenic diet in epilepsy.
        JAMA. 1925; 84: 1979-1983
        • McQuarrie
        • Keith H.M.
        Epilepsy in children: relationship of variations in the degree of ketonuria to occurrence of convulsions in epileptic children on ketogenic diets.
        Am J Dis Child. 1927; 34: 1013-1029
        • Helmholz H.F.
        Treatment of epilepsy in childhood: five years’ experience with the ketogenic diet.
        JAMA. 1927; 88: 2028-2032
        • Merritt H.H.
        • Putnam T.J.
        Sodium diphenylhydantoin in the treatment of convulsive disorders.
        JAMA. 1938; 111: 1068
        • Talbot F.B.
        Treatment of epilepsy.
        MacMillan, New York1930
        • Wilkins L.
        Epilepsy in childhood: III. Results with the ketogenic diet.
        J Pediatr. 1937; 10: 341-357
        • Livingston S.
        The diagnosis and treatment of convulsive disorders in children.
        Charles C Thomas, Springfield1954
        • Livingston S.
        Dietary treatment of epilepsy.
        in: Comprehensive management of epilepsy in infancy, childhood, and adolescence. Charles C. Thomas, Springfield, IL1972: 378-405
        • Kinsman S.L.
        • Vining E.P.G.
        • Quaskey S.A.
        • Mellits D.
        • Freeman J.M.
        Efficacy of the ketogenic diet for intractable seizure disorders: review of 58 cases.
        Epilepsia. 1992; 33: 1132-1136
        • Huttenlocher P.R.
        • Wilbourn A.J.
        • Signore J.M.
        Medium-chain triglyceride as a therapy for intractable childhood epilepsy.
        Neurology. 1971; 21: 1097-1103
        • Trauner D.A.
        Medium-chain triglyceride (MCT) diet in intractable seizure disorders.
        Neurology. 1985; 35: 237-238
        • Gordon N.
        Medium-chain triglycerides in a ketogenic diet.
        Dev Med Child Neurol. 1977; 19: 535-544
        • Swink T.D.
        • Vining E.P.
        • Freeman J.M.
        The ketogenic diet: 1997.
        Advances in Pediatrics. 1997; 44: 297-329
        • Freeman J.M.
        • Freeman J.B.
        • Kelly M.T.
        The ketogenic diet: a treatment for epilepsy.
        3rd ed. Demos, New York2000
        • Freeman J.M.
        • Vining E.P.G.
        • Pillas D.J.
        • Pyzik P.L.
        • Casey J.C.
        • Kelly M.T.
        The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children.
        Pediatrics. 1998; 102: 1358-1363
        • Hemingway C.
        • Freeman J.M.
        • Pillas D.J.
        • Pyzik P.L.
        The ketogenic diet: a 3–6 year follow-up of 150 children prospectively enrolled.
        Pediatrics. 2001; 108: 898-905
        • Hemingway C.
        • Pyzik P.L.
        • Freeman J.M.
        Changing physician attitudes toward the ketogenic diet: a “parent-centered” approach to physician education about a medical alternative.
        Epilepsy Behav. 2001; 2: 574-578
        • Thiele E.A.
        Assessing the efficacy of antiepileptic treatments: the ketogenic diet.
        Epilepsia. 2003; 44: 26-29