Some Kids on Epilepsy Diet Still Seizure-Free
It makes a huge change in how the body gets its energy. The big question is why this change stops seizures in some people with epilepsy.
"We don't have any idea why it works," Freeman says. "It seems to work on different seizure types in different-age children. In 1995, very few people in the epilepsy community believed it worked. I think now everybody says, 'Well, we knew all the time that it worked.' This is the first really long-term study that shows the diet not only is effective but that the effect remains long after the diet is gone."
Not every expert agrees that the keto diet works as often in real life as it does at the Johns Hopkins center. Wendy Gayle Mitchell, MD, is professor of neurology and pediatrics at the University of Southern California and professional advisor to the Los Angeles County Epilepsy Society. Gayle says that the fame of Freeman's program attracts many parents whose children have not truly exhausted all other medical options.
"Most centers don't have as spectacular results as he does," Mitchell tells WebMD. "While we find the diet useful occasionally, if patients are chosen who are really [untreatable by all antiseizure drugs], the number who will have complete [relief from] their seizures is miniscule."
Many other medical centers use one form or another of the diet. One such program is the Epilepsy Center at St. Louis Children's Hospital. Susan T. Arnold, MD, is the program's co-director.
"We do use the keto diet a fair amount. We've had more than 100 children on it in the last eight years or so. I don't think it is a miracle cure for epilepsy, but I certainly don't think it is crazy or all due to choosing easy patients. Most kids on the keto diet [get little relief from] many medications. I do think if you select patients well you can have a very good response rate. I don't think it is right for every kid with seizures."
Freeman says that the limited success of the keto diet may offer a clue to the basic causes of epilepsy -- and to better treatments.