Epilepsy, one of the most common neurological conditions, causes repeated seizures in people of all ages, and is seen in approximately 50 million people worldwide. [67] It is not uncommon to experience one seizure during your lifetime – this does not signify epilepsy.
An epileptic seizure, also known as a fit, occurs due to abnormal electrical activity in the brain. Specialised electrically-excitable nerve cells in the brain (called neurons) transmit electrical and chemical signals.
Seizures take place due to irregular bouts of electrical impulses from neurons, which result in varied responses. It can range from slight muscle jerks and loss of concentration, to violent, uncontrollable shaking, and loss of consciousness.
Symptoms
The main symptom of epilepsy is long-term recurrent seizures. Depending on the portion of brain that is affected, the type of seizure and its severity are different. Partial seizures occur when a small portion of the brain is affected, and generalised seizures occur when the majority of the brain is affected.
Partial seizures
Partial seizures come in two forms, known as simple partial seizures and complex partial seizures. Symptoms of simple partial seizures include:
- General feelings of unease
- Strange feelings in your stomach, like that of nervousness
- Intense déjà vu (feeling that something has happened before)
- Unusual tastes and smells
- Pins and needles (tingling) in the arms and legs
- Intense bouts of fear, or joy
- Twitching or stiffness in body parts
Simple partial seizures are occasionally followed by other types of seizures, and are consequently known as warning seizures. This type of seizure can give you chance to warn other people and get to a safe place.
When complex partial seizures occur, people have no sense of awareness, and won’t remember what happened after the seizure has finished. Complex partial seizures usually entail strange bodily behaviour, and symptoms include:
- Loss of awareness, and blankly staring at nothing in particular
- Automatisms: adopting an unusual posture, chewing or swallowing, fiddling with objects, moving their arms around, picking at clothes, rubbing their hands and smacking their lips
- Making random noises and repeating words
Generalised seizures
There are six types of generalised seizures:
- Absence seizures: these cause a short vacancy period – usually 15 seconds – in which all awareness is lost. These seizures can occur multiple times per day, and there will be no memory of them after they have finished.
- Atonic seizures: these cause your muscles to relax, which may make you fall on the floor.
- Clonic seizures: these are attributed to a loss of consciousness, and jerking and twitching in both your upper and lower body. Lasting for a few minutes, they are quite rare.
- Myoclonic seizures: these are similar to clonic seizures, although they only last for a few seconds, are more likely. Also, sufferers usually remain conscious.
- Tonic seizures: these cause sudden stiffness in the muscles, sometimes causing sufferers to lose balance and injure themselves. These seizures usually only last for around 20 seconds.
- Tonic-clonic seizures: these are the seizures people most associate with epileptic fits. Tonic-clonic seizures are tonic seizures followed by clonic seizures. These seizures usually last for a few minutes, but have been known to last longer occasionally.
Cause
In the majority of cases, the cause of epilepsy is unidentifiable, being known as idiopathic epilepsy. It is assumed that genetics play a role in the development of epilepsy, although no studies have shown a strong relationship between particular genes and epilepsy. It is thought that idiopathic epilepsy may be caused by damage to the brain that’s not visible with current medical equipment.
Symptomatic epilepsy refers to epilepsy that has a known cause. These causes include:
- Brain tumors
- Cerebrovascular disease (oxygen deprivation in the brain) such as strokes and brain haemorrhages
- Drug abuse (including alcohol)
- Head injuries
- Infections that damage the brain
Certain things can trigger seizures in people that have epilepsy:
- Alcohol
- Flashing lights
- Lack of sleep
- Medication and illegal drugs
Ketogenic diet treatment for epilepsy
In some people, seizures can be controlled through the use of medications, but many people become resistant to the medication.
In those with drug-resistant epilepsy, a ketogenic (high-fat, moderate-protein and low-carbohydrate) diet may help seizure control. Between 50 and 60 per cent of people will eventually become seizure-free after using the first seizure medicine they try. [68]
For those who do not become fully seizure-free, ketogenic diets have been shown to still reduce seizure rate by 85 per cent in three months, and prevent seizures altogether in 50 per cent of people on a 4:1 ketosis diet. [69] A 4:1 ketosis diet refers to the ratio of fat to the ratio of carbohydrates and protein.
Although the ketogenic diet has been used to treat epilepsy for a very long time, the reason it works is still unknown.
When small quantities of carbs are consumed, and no glucose is present, the body reverts to a metabolic process in which fats are used for energy. Ketone bodies are a by-product of fat metabolism. These chemicals are thought to reduce seizures in people.
The focus should be on eating foods that contain lots of healthy monounsaturated fats, polyunsaturated fats, and protein. Foods to eat include:
- Meat: poultry, beef, pork and game meat (grass fed and organic are best)
- Fish: salmon, mackerel, herring, cod and haddock (wild fish are best)
- Organic eggs
- Low-carb vegetables: parsley, spinach, bok choi, endive, lettuce, alfalfa sprouts, cauliflower, broccoli, zucchini, cucumber and cabbage (organic is best)
- Full-fat dairy: cheese, butter, cream and Greek yoghurt (apart from milk, as it contains sugar)
- Low-carb nuts: macadamia nuts, brazil nuts, pecans and walnuts (hazelnuts, almonds and peanuts in moderation)
Avoid the following:
- Sugar: sweets, chocolate, ice cream, soft drinks and fruit juice
- Grains and veg grown underground: pasta, bread, rice, potato, sweet potato, porridge, breakfast cereal, parsnip, chips and crisps
- Trans fats, vegetable oils and omega-6 fats: hydrogenated oils, sunflower, safflower, soybean, cottonseed and corn oils
- Processed meats: bacon, salami, luncheon meat and sausages
Many people may think such diets are not appetising. However, meals on this diet can be surprisingly tasty.
A normal breakfast could consist of mushroom omelette, several bacon slices and hot chocolate with 36 per cent cream. Lunch could be celery stalks with peanut butter, lettuce, mayonnaise and tomato. A mid-afternoon snack could consist of smoked salmon and avocado. Dinner could be a specifically-weighed portion of hot dog, complete with low-sugar ketchup, mustard, lettuce and mayonnaise, as well as a low sugar whipped cream sundae with raspberries and a diet drink.
It may be helpful to keep a seizure diary to try and identify any hidden seizure triggers. After a seizure, record the time and date, and the type and severity of seizure. Additionally, record any possible triggers, including tiredness, alcohol and food consumption, flashing lights, missing meals, menstruation or stress.
People who attain complete seizure control through this dietary approach often discontinue the ketosis method after around two seizure-free years.
It is not uncommon for people to stay on this diet until it no longer proves effective as a treatment method. It is advised to decrease the ratio of fat to carbs and protein gradually, instead of aggressively adding carbs back into the diet.
