Preliminary findings in a study of the ketogenic diet have given additional credence to the effectiveness of the high-fat, low-carbohydrate diet in reducing epileptic seizures in children. In monitoring the seizure frequency in children with atonic or myoclonic seizures, Johns Hopkins Children's Center researchers were able to demonstrate that induced ketosis, the incomplete burning of fat, decreased seizures in 50 percent of the children and eliminated them entirely in some. They report as well an easily reproducible demonstration of ketosis manipulation.

In the study, published in the Archives of Pediatric and Adolescent Medicine, 17 children with Lennox-Gastaut syndrome, a form of pediatric epilepsy, fasted for 36 hours. A controlled ketogenic diet was then introduced gradually over three days. Parents maintained a diary of the frequency of seizures before and during the diet. Additionally, using a 24-hour portable electroencephalogram to monitor neurologic brain functions, the researchers measured the exact number of seizures in some of the children before and after the diet.

Immediately after initiation of the diet, seizures decreased profoundly in 50 percent of the children, and completely stopped in some. In electronically monitored children, researchers also noted that the recorded number of seizures exceeded that reported by parents prior to initiation of the diet, indicating that parental estimates may not always be accurate.

In one such child, researchers tracked the actual process of ketosis in a crossover study. After fasting and then beginning the diet, the child became ketotic. When she was given a glucose solution, however, ketosis rapidly disappeared. The child fasted again and was given the saccharine solution with the diet. Ketosis developed again, and was maintained.

"It's unusual for researchers to publish preliminary studies," says John Freeman, director of the Children's Center's pediatric epilepsy program, who co-authored the study with colleague Eileen Vining. "In this case, however, we wanted to share these initial results with other clinicians and parents to show how fast this diet can work and that one can study the diet in a crossover fashion. We hope this double-blind study will document the demonstrated efficacy of the diet and lead to its more widespread use in appropriate populations."