The prevalence of epilepsy in Korea is about 1%, and about one in five children and adolescents under the age of 20. Brain tumors, strokes, and trauma are the main causes of adults, but in children and adolescents, innate brain deformities or genetic abnormalities are often the cause of epilepsy.
Park So-young, a professor of pediatrics at Soonchunhyang University Bucheon Hospital, said, "In general, if you have more than two seizures at intervals of 24 hours or more, you should suspect epilepsy. If necessary, we confirm it through brain waves, brain MRI, brain metabolism (Brain PET), nuclear medicine brain blood flow (Brain SPECT), and genetic tests." Epilepsy is a disease that is difficult to predict but sufficiently manageable. Treatment is largely divided into drug and non-drug treatment, with 70-80% controlled seizures with drugs such as anticonvulsants.
In addition, the so-called "incurable epilepsy," which is difficult to treat with drugs, can also control symptoms to the extent that daily life is possible through treatment that directly deals with the brain, such as surgery or brain deep stimulation. In particular, one of the recommended non-surgical treatments for epilepsy is "ketone-generating diet" (hereinafter referred to as ketone-style). It refers to the so-called "low carb" diet, which consists of 3 to 5 to 1 ratio of fat to carbohydrate + protein.
Choi Joon-young, a professor of neurology at Ajou University Hospital, said, "If you limit carbohydrates, which are the main energy source of the brain, and use fat as an energy source, ketone bodies are estimated to be produced in the metabolic process.
The effect is powerful. In children, about one-third of children who have undergone ketone therapy have reduced convulsions by more than 90%. The younger the person is, the more effective the treatment is.
Recently, the effect of ketone-style epilepsy treatment has also been confirmed in adults. A research team at Ajou University Hospital divided 140 inpatients with intractable epilepsy (32) who could not have seizures with two to three anticonvulsants, with one (32) eating ketone meals and the other (108) eating regular meals. More than 80% of the groups ate ketone meals stopped seizures within 1-2 days.
In addition, the physical function score (mRS, which is higher than 6 points) measured twice at the time of discharge and 3 months after discharge was found to have improved symptoms by 1.74 points and 1.66 points, respectively, compared to the group that ate regular meals (Neurotherapeutics, 2022).
Professor Choi Joon-young explained, "Electronics superposition is a very dangerous serious disease with a mortality rate of 11-48% as seizures continue without stopping," adding, "This study is meaningful in proving ketone-style effects not only in children but also in adults." In the ketone diet, it is most important to maintain the ratio of fat, carbohydrates, and proteins. They avoid sweet foods such as candy, chocolate, and honey, or carbohydrate diets such as rice, bread, and noodles, and eat a lot of fatty nuts, butter, and cream. Recently, more and more ordinary people choose ketone for diet purposes. However, experts share the common opinion that although it is effective in temporarily losing weight and improving blood sugar, safety is not verified when it lasts for a long time, so caution. There is also a meta-analysis study result (PLoS One, 2013) that excessively limiting carbohydrate intake significantly increases mortality, which has more disadvantages than advantages.
Professor Choi said, "Pediatric epilepsy patients only maintain ketone meals for about two years, and adult epilepsy patients also gradually take regular meals when they stop convulsions and regain consciousness." He advised that ordinary people should refrain from hastily changing their diet to ketone style.
Writer: Yeyoung Jeon
(Picture from Unsplash)
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