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Seizures and Epilepsy

What is epilepsy?

Epilepsy is a neurological condition involving the brain that makes people more susceptible to having seizures. It is one of the most common disorders of the nervous system and affects people of all ages, races and ethnic background. More than 2.7 million Americans live with epilepsy.

When a person has two or more seizures, he or she is considered to have epilepsy. There are many possible causes of epilepsy, including tumors, strokes, and brain damage from illness or injury. In many cases, there may be no detectable cause for epilepsy.

What is a seizure?

The brain is the center that controls and regulates all voluntary and involuntary responses in the body. It consists of nerve cells that normally communicate with each other through electrical activity.

A seizure occurs when part(s) of the brain receives a burst of abnormal electrical signals that temporarily interrupts normal electrical brain function.

What are the different types of seizures?

There are several different types of seizures in children, including the following:

What causes a seizure?

A child may experience one or many seizures. While the exact cause of the seizure may not be known, the more common seizures are caused by the following:

What are the symptoms of a seizure?

The child may have varying degrees of symptoms depending upon the type of seizure. The following are general symptoms of a seizure or warning signs that your child may be experiencing seizures. Symptoms or warning signs may include:

During the seizure, the child's lips may become bluish and breathing may not be normal. The movements are often followed by a period of sleep or disorientation.

The symptoms of a seizure may resemble other problems or medical conditions. Always consult your child's physician for a diagnosis.

How are seizures diagnosed?

The full extent of the seizure may not be completely understood immediately after onset of symptoms, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The diagnosis of a seizure is made with a physical examination and diagnostic tests. During the examination, the physician obtains a complete medical history of the child and family and asks when the seizures occurred. Seizures may be due to neurological problems and require further medical follow up.

Diagnostic tests may include:

Treatment of a seizure:

Specific treatment for a seizure will be determined by your child's physician based on:

The goal of seizure management is to control, stop, or decrease the frequency of the seizures without interfering with the child's normal growth and development. The major goals of seizure management include the following:

Treatment may include:

What is a ketogenic diet?
The ketogenic diet is sometimes offered to those children who continue to have seizures while on seizure medication. When the medications do not work, a ketogenic diet may be considered. No one knows exactly how the diet works, but some children do become seizure-free when put on the diet. However, the diet does not work for everyone.

What does the diet consist of?
The ketogenic diet is very high in fat (about 90 percent of the calories come from fat). Protein is given in amounts to help promote growth. A very small amount of carbohydrate is included in the diet. This very high- fat, low- carbohydrate diet causes the body to make ketones. Ketones are made by the body from protein. They are made for energy when the body does not get enough carbohydrates for energy. If your child eats too many carbohydrates, then his/her body may not make ketones. The presence of ketones is important to the success of the diet.

High-fat foods:

  • butter
  • heavy cream
  • oil
  • mayonnaise
  • cream cheese
  • bacon
  • cheese

High-carbohydrate foods:

  • fruit and fruit juice
  • breads and cereals
  • vegetables (corn, peas, and potatoes)
  • beans
  • milk
  • soda
  • snack foods (chips, snack cakes, crackers)
  • sweets

Your child's physician will determine if this diet is right for your child. When the ketogenic diet is started, your child will be admitted to the hospital. It may take four to five days in the hospital to get the diet started and for you to learn how to plan the diet.

While in the hospital, your child may not be able to eat for one to two days until ketones are measured in the urine. Once ketones are present in the urine, special high-fat, low-carbohydrate shakes may be started. These are sometimes called "keto shakes." After several meals of keto shakes, your child will be started on solid foods.

You may also be taught how to check your child's urine for ketones. The dietitian will help determine how much fat, protein, and carbohydrate your child is allowed to have, usually divided into three meals a day. The ketogenic diet can by very challenging to prepare and requires that all foods be weighed using a food scale. The ketogenic diet is not nutritionally balanced, therefore, vitamin and mineral supplements are needed.

Some medications and other products, such as toothpaste and mouthwash, contain carbohydrates. It is important to avoid these products if your child is on the ketogenic diet. Your child may not make ketones in their urine if too many carbohydrates are included in the diet. Your child's physician and dietitian can give you a list of medications, and other products, that are free of carbohydrates.

How long is the diet used?
Children usually stay on the diet about two years. The diet is then slowly changed back to a regular diet.

Sample ketogenic meal:

Sample ketogenic shake:

60 g heavy cream

500 g Ross Carbohydrate-free Formula (concentrate)

21 g strawberries

270 g heavy cream

53 g eggs

13 g Egg Beaters®

10 g cheddar cheese

 

10 g bacon

 

21 g butter

 

Additional treatment options:

More information regarding the child with seizures or epilepsy:

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