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The Classic Ketogenic Diet that was developed at Johns Hopkins Hospital
is a labor intensive metabolic therapy with rigidly calculated meal
plans.
 Meals
are high in fat, low in carbohydrates and protein to produce a high
blood concentration of incompletely burned fat molecules called ketone
bodies. Slight fluid restriction increases concentration of the ketone
bodies and is useful for optimum effect. The state of ketosis is monitored
in the urine while moderate to heavy ketosis is attempted.
The
exact mechanism by which the Diet obtains seizure control is unknown.
Ketosis, dehydration and acidosis each appear to play a role. The hypothesis,
which arrived out of the Epilepsy and Brain Mapping's recent research,
suggests that there is an alteration in the (1) acid-base balance; (2)
water and electrolyte distribution; (3) lipid concentration (4) brain
energy reserve or (5) a central action of ketones on the brain.
It
wasn't until 1993, when film producer, Jim Abrahams discovered the Diet
for his son, Charlie, that a resurgence began within the medical community.
From
Jim and his wife Nancy's experience, they developed the Charlie Foundation
to inform people about the Diet.
The
Ketogenic Diet has been refined as a rigid metabolic therapy for epilepsy
patients.
The
usual candidate for the Diet is a patient with medically intractable
generalized seizures which are not amenable to medications or surgery.
The
results are showing promise in controlling seizures in young children
and some adults. Currently, 51% of our Epilepsy and Brain Mapping Program
patients are either 90% improved or seizure free.
What is the ketogenic diet?
The ketogenic diet is a stringent, mathematically calculated
diet high in fat and low in protein and carbohydrates that, when followed
conscientiously, produces a by-product called ketones in patients'
blood and urine. High concentrations of ketones in the body control
the frequency and severity of seizures, although the biochemical mechanisms
for this phenomenon are not yet known.
What
is known, however, is that since the diet was first developed and
implemented at the prestigious Mayo Clinic and Johns Hopkins University
medical schools, many seizure patients have shown marked improvements.
Recent clinical studies, including the 1992 Johns Hopkins report published
in Epilepsia, attest to the effectiveness of the diet.
Most
patients remain on this diet for at least two years, during which
time medications may be reduced and even discontinued. Although the
diet is high-fat, patients do not gain weight because their caloric
intake is restricted to 75 percent of their required daily allowance.
The diet is supplemented with vitamins and calcium, so patients do
not suffer from any nutritional imbalance.
After
two years on the strict regimen, many patients remain seizure-free
and no longer require anticonvulsant drugs or the diet. Others demonstrate
great gains, but may need to continue their medications and the diet
indefinitely.
| Cheese
Omlet |
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Ingredients:
Egg, Cheese, Onion, Tomato,
Margarine, Vanilla, ®Sweet10,
Salt & Pepper, Heavy Whipping Cream
Directions:
Scramble egg and weigh. Add a little of allotted cream, salt
and pepper. Pour into heated pan coated with vegetable cooking
spray. Spread cheese, onion and tomato on egg. Then flip top
over to make omelet and cook a few more minutes until done.
Add margarine to cooked omelet. Serve diluted vanilla and ®Sweet
10 flavored cream as a beverage.
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The Ketogenic Diet at the Epilepsy
and Brain Mapping Program
The Epilepsy and Brain Mapping Program has led the way
in the treatment of epilepsy. Dedicated to finding the best solutions,
neurologist William Sutherling, M.D., medical director has established
a comprehensive epilepsy program that allows patients and families
as many options as possible, whether they be medical, surgical or
dietary.
Pediatric
neurologist Roger Huf, M.D. heads the ketogenic diet team, which also
includes Dr. Sutherling, a nurse clinician and a registered dietitian,
who all received extensive training in the ketogenic diet at Johns
Hopkins University's medical school. In fact, all of EBMP's registered
dietitians and special epilepsy nurses have undergone training in
the diet, so they can provide needed support and instruction to ensure
the patient's dietary compliance.
Family
preparation begins as soon as patients are considered viable candidates
for the diet. The Epilepsy and Brain Mapping Program's team provides
families with extensive educational materials and personalized instruction
about maximizing dietary compliance in home environments. During inpatient
assessment, patients, along with their families, meet daily with the
dietitian to obtain a better understanding of dietary requirements.
At this time, patients are gradually initiated into the diet, so that
by the time they are discharged from the hospital, they are prepared
to accept the ketogenic regimen fully.
To
help patients and families comply with the ketogenic diet, Epilepsy
and Brain Mapping's team offers maximal support and instruction. Questions
and concerns can be addressed promptly by phone, fax or Internet.
Success in any ketogenic program is in direct proportion to the amount
of individualized attention patients and families receive from their
health-care team. At EBMP, Drs. Huf and Sutherling and their team
provide the utmost to optimize success.
Who is eligible for the ketogenic
diet?
Epilepsy patients must meet certain
criteria:
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They previously must have tried two anti-convulsant
medications.
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They must undergo an evaluation by their own neurologist
and EBMP's ketogenic team to determine their seizure type.
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They or their families must demonstrate an ability
to understand the ketogenic diet and the importance of adhering
to its specific requirements.
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Patients and families must be highly motivated in
following the diet.
Dr. Sutherling and his staff have years of experience
in tendering outstanding, compassionate care to epilepsy patients
and their families. They are known throughout the patient and medical
communities for their work with children and their patients.
Stories
Of Courage, Inspiration and Success
Seizure And Medication Free At Last
With The Ketogenic Diet
With infectious enthusiasm, young Justin Hein doesn't
miss a beat as he jumps off the backyard trampoline, chases the family
dog and hugs his nine year old brother, Sam. Like any other boy his
age, Justin is free to explore his world with gusto.
That
wasn't the case a few years ago when he was suffering from up to as
many as five uncontrollable seizures a day. After trying several anti-epileptic
medications without success, the Hein's were referred to EBMP to the
Ketogenic Diet by their local pediatric neurologist.
After
a hospital evaluation it was determined that Justin would be a good
candidate for the diet. His family dedicated themselves to the rigors
of the Ketogenic Diet regimen for two years.
As
a high fat, low carbohydrate and low protein diet, the Ketogenic Diet
is a medical therapy which is carefully administered to produce ketones
in the body. This in turn helps suppress and/or eliminate seizures
for many pediatric patients. Every liquid and food has to be carefully
measured.
On
a few occasions, Justin experienced seizures as a result of cheating
but the family continued their vigilance by locking down their cabinets
and hiding all of the trash baskets. As Rose says, "It wasn't an easy
time. Everything from TV commercials to social gatherings, revolves
around food. But, seeing the fog lift in Justin's eyes, made our commitment
to the diet that much stronger."
Today,
Justin is completely off of the diet, seizure and medication free.
He's able to attend birthday parties and eat whatever he likes.
A Karate Champion's Tale
Of Success And Courage
These days 15 year old Alessandro Azzato has experienced
an amazing story of success and courage as a result of the Ketogenic
Diet.
With
more first place Karate Championship Awards than anyone can count,
Alessandro is now enjoying, as he says, "A regular life filled with
afterschool activities, video games, homework and Karate."
This
wasn't the case four years ago when he remembers the times the hospital
was his second home.
Suffering
from up to hundreds of seizures a day with no hope of managing them,
one of his doctor's finally told his mom, Denise Azzato, "To love
him, hug him and hope he makes it to see his 13th birthday."
After
trying 10 different anti-epileptic medications without success or
hope, Alessandro's family felt even more devastated.
As
Denise says, "The hardest part was actually watching him experience
language and memory reversals. His days were spent mostly sleeping
and barely functioning. These were bleak years for us filled with
memories of rushing Alessandro to the hospital emergency room, wondering
if he could live through another day of status epilepticus."
"Then,
one day, we learned of the Ketogenic Diet program. After placing him
on it, we saw him literally wake up, focus and become alert once again.
It was truly a miracle for him and our entire family."
With
special instructions for his teachers and caregivers, Alessandro has
been able to maintain the rigors of the diet at school as well as
at home.
Although
still on the diet, Alessandro's seizures are well managed allowing
him to enjoy many academic and athletic activities that had once eluded
him.
To
receive more information about our ketogenic diet program, or to refer
patients, call (626) 792-7300 or
(800) 621-2102. FAX: (626) 792-7336.
e-mail: info@epipro.com
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