Does anyone know why ketogenic diets work for epilepsy?

Hi, I wonder if anyone who knows about using the ketogenic diet for (usually childhood) epilepsy knows exactly why it works? I don't suffer from epilepsy but I have a rare condition called Trigeminal Neuralgia which has some similarities: it is treated with anti-convulsants and it features damaged/erratic neural firing (acute electric shock pain in the trigeminal nerve).

I have a theory that TN may be part of Metabolic Syndrome and just isn't recognised as such. Given that Metabolic Syndrome can effectively be treated with very low carb or ketogenic diets I wondered if it might be effective for my TN.

Although I've read about the ketogenic diet being highly successful in reducing or curing childhood epilepsy I've never seen any information as to why or how it does this.

I'd be grateful if anyone who knows about the diet or knows any research on the whys and hows of it could get in touch and share their wisdom. Many thanks!

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  • ncbi.nlm.nih.gov/pmc/articl...

    This too;

    This is an abstract from one paper on 'dietary therapies for epilepsy':

    'Abstract

    Since their introduction in 1921, high-fat, low-carbohydrate "ketogenic" diets have been used worldwide for refractory childhood epilepsy. Approximately half of the children have at least half their seizures reduced, including 15% who are seizure free. The mechanisms of action of dietary therapies are under active investigation and appear to involve mitochondria. Once perceived as a last resort, modifications to initiation and maintenance, as well as the widespread use of pre-made ketogenic formulas have allowed dietary treatment to be used earlier in the course of epilepsy. For infantile spasms (West syndrome) specifically, the ketogenic diet is successful about 50% of the time as a first-line treatment. New "alternative" diets such as the modified Atkins diet were created in 2003 and can be started more easily and are less restrictive. They may have particular value for countries in Asia. Side effects include constipation, dyslipidemia, growth slowing, acidosis, and kidney stones. Additionally, neurologists are studying ketogenic diets for conditions other than epilepsy, including Alzheimer's disease, autism, and brain tumors.'

    I'm interested in this from a research point of view.

    Meryll Streep also did a made for TV film about the diet. Many of the parts were played by people who had been controlled on it for years. Its probably on IMDB under her films. Though it doesn't explain how the diet works it is really about how screwed you can be in America if you have no medical insurance and a family member develops a chronic illness and nothing seems to work.

    If you want any more info give me a shout I have a load of papers.

  • That was a REALLY interesting paper, thank you. The most interesting thing for me is right at the end where they mention, almost in passing, that there is some evidence of it working in migraines. I suffer with migraines intermittently, but, more importantly there is a strong connection between TN sufferers and migraine (there are far more migraine sufferers in the TN population that the normal population), so, ipso facto, you'd think if migraines & TN are connected and the ketogenic diet works on migraines then it may well work on TN.

    I tried to discuss this with my TN forum but I don't think anyone had ever gone on a ketogenic diet so no correlation has ever been made anecdotally. While low-carb is well known, it tends to be for weight loss and isn't as extreme as true ketogenic diets. One of the biggest problems with TN is it is a rare condition so very little research gets done and virtually none on causes, it's all about pain management. Additionally, I think when people are in the active cycles they are in so much pain/doped up they couldn't face doing a ketogenic diet at the same time! In fact, TN would probably make a ketogenic diet difficult because chewing meat is well-nigh impossible sometimes.

    But I'd certainly be grateful for any other links you may have to any research on other neurological disorders/ketogenic diets (rather than use in epilepsy) or, God forbid, any that mention TN (unlikely!)

    Thanks again; it was really helpful.

  • I'll see if I can find anything about Migraine as that seems to be a likely correlation.

  • I might have found better. Does this help you? Please give me a shout if it is off the mark. My laptop is pretty well trained now.

    file.scirp.org/pdf/OJPM_201...

    Hope it is of some use to you, if you need more get in touch.

  • That's another really interesting paper, for entirely different reasons - they are advocating the complete opposite of a ketogenic diet! Zero fat as opposed to all fat.

    I've come across the LFD for MS before. In fact, I read a book on the subject recently, but I am sceptical about it for one very significant reason. Before I came down with TN I had been on a VLFD (as in virtually zero fat, well below what this paper's diet recommends) for a year and a half. This was forced on me by being very ill with gallstones.

    After I had my gallbladder removed I reintroduced fats, quite slowly, and a while after that I came down with TN. My B12 was low because of the low fat diet, but I always felt that the low fat itself had possibly caused the TN problems. After all, your brain needs fat to function.

    That said, there is another way of looking at it, that yes, my B12 had suffered and that may have been a triggering factor, but it also may have been the reintroduction of fat that triggered TN. It's possible...

    My only concern with this study is it is self-reported, both on how well they complied to the diet (people lie about what they eat!) and also on how much their pain improved. It is possible that their TN improved simply because they were eating BETTER rather than just low fat.

    I'm going to go to my TN forum and ask if anyone has ever tried this and refer them to this study. Thanks a lot for this; it's given me a lot to think about. X

  • No problem, glad to help

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