Dietary Treatment of Epilepsy

Epilepsy is a common chronic neurological disorder characterised by recurrent unprovoked seizures, and affects 50 million people worldwide. Approximately 30% of these do not have seizure control even with the best available medications, hence renewed and increasing interest in the use of dietary treatments to treat epilepsy. These treatments include the traditional ketogenic diets but also the newer modified Atkins diet and low glycaemic index treatment. The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat refractory epilepsy in children, and requires the dedicated support of a multi-disciplinary team including doctors and dietitians. Dietary Treatment of Epilepsy: Practical Implementation of Ketogenic Therapy provides comprehensive and practical training on all aspects of implementing and managing dietary treatments for epilepsy, with key chapters on assessment, calculations, implementation, monitoring and complications. Edited by a highly respected expert in the field supported by a strong team of contributors, this is a must-have resource for paediatric dietitians and other members of the therapy team. CONTENTS Section 1 Introduction and Overview 1 1 Introduction to the ketogenic diet and other dietary treatments 3 Elizabeth Neal 2 Epilepsy and epileptic seizures 11 J. Helen Cross 3 Treatment options in the paediatric epilepsy clinic 19 Ruth E. Williams 4 Efficacy of ketogenic dietary therapy: what is the evidence? 24 Eric H. Kossoff 5 The biochemical basis of dietary therapies for neurological disorders 34 Adam L. Hartman and Jong M. Rho Section 2 Clinical Implementation 45 6 Preparing for dietary treatment 47 Georgiana Fitzsimmons 7 The challenge of therapeutic diets in children with pre-existing feeding problems 58 Bridget Lambert and Mary-Anne Leung 8 The classical ketogenic diet 66 Gwyneth Magrath and Elizabeth Neal 9 The medium-chain triglyceride ketogenic diet 78 Elizabeth Neal 10 The modified Atkins diet 89 Gwyneth Magrath, Mary-Anne Leung and Tara Randall 11 The Low Glycaemic Index Treatment 100 Heidi H. Pfeifer 12 Managing dietary treatment: further dietetic issues 109 Jan Chapple 13 Managing dietary treatment: a parent’s perspective 116 Emma Williams 14 Enteral feeding 124 Jan Chapple 15 Dietary initiation 131 Jan Chapple 16 Ketone monitoring and management of illness 135 Hannah Chaffe 17 Fine tuning 142 Gwyneth Magrath 18 Monitoring and side effects 149 Elizabeth Neal 19 Dietary treatments and bone health 159 Christina Bergqvist 20 Carnitine 166 Elizabeth Neal 21 Switching or discontinuing dietary treatment 172 Bridget Lambert Section 3 Broader Applications 179 22 Dietary treatment of epilepsy in infants 181 Nicole Dos Santos 23 Dietary treatment of epilepsy in adults 189 Susan Wood 24 Ketogenic dietary therapy in India 198 Janak Nathan 25 Ketogenic dietary therapy in East Asia 206 Hoon-Chul Kang and Heung Dong Kim 26 Ketogenic dietary therapy in Africa 215 Tuscha Du Toit 27 Ketogenic dietary therapy in neurometabolic disease 220 Joerg Klepper 28 Beyond epilepsy: ketogenic diet use in other disease states 225 Adam L. Hartman and Jong M. Rho Afterword 232 Appendix 234 Index 235