Kara was a three- year old girl who had been having uncontrollable seizures for the past year from an unknown cause. She would normally have about 6-8 ?drop? seizures per day and many ?staring spells.? She was being given four different medications to control various symptoms of her seizure activity, and her mother was very concerned that these medications made her sleepy and unable to participate in many activities the family had once enjoyed. Kara was not able to regularly attend preschool because of unsteadiness and frequent falls caused by the seizures.
The nutritionist met with Kara and her mother to discuss starting the ketogenic diet, a diet thought to help control seizure activity. Kara?s mother had read about the diet in a children?s magazine and was very interested in trying to help Kara become ?seizure free without her medications. On the day of their initial referral, Kara was wearing a bicycle helmet to protect her head and had many bruises from where she had fallen.
The family decided to pursue the diet, so Kara was admitted to the hospital for four days. Her blood sugar level was carefully monitored since she had to fast for about 24 hours before she spilled ketones in her urine (ketones are spilled in the urine when the body uses fat instead of carbohydrate for its main source of energy-this is thought to be the ?key? to controlling seizures). Once this occurred, she was started on a carefully calculated diet containing specific amounts of fat, protein and carbohydrate. The family was provided with intense nutrition counseling on how to administer the diet at home, what foods to buy and how to read food labels to ensure that Kara did not eat foods that would take her out of ketosis and cause the seizures to return. She was discharged home after four days with about 12 meal plans to follow on a 4:1 ratio (4 parts fat to 1 part protein and carbohydrate).
Over the course of the next six months, many adjustments were made in Kara?s diet based on her amount of seizure activity and her tolerance to the diet. Her weight and height remained steady during this time frame and she received a multivitamin and calcium supplement in her diet that would not interfere with her diet ratio (some of the medicines contain carbohydrates, which would alter her ratio and could increase seizures). She was seen monthly by the nutritionist, and Kara?s mother frequently called nutritionist with questions or requests for alternate menus.
Ten months after the diet was initiated, Kara no longer had staring seizures and her drop seizures occurred very infrequently. She was now running, playing with other kids, and was more interactive at home and in preschool. She was able to stop three of her four seizure medications over time and her diet ratio was slowly increased to add more starch and protein into her diet. When the nutritionist last saw Kara, she was four years old, taking dance and gymnastics and had received a bike with training wheels for her birthday. She was slowly weaning off the diet and the last of her seizure medications.
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