Epilepsy | Ketogenic and Modified Atkins Diet

Controlling Seizures Through Specialized Diets

Specialized diets can help some children achieve seizure control when anti-seizure medications are not effective. These diets include the ketogenic diet and the modified Atkins diet, both of which are high in fat, low in carbohydrates and have a moderate amount of protein.

These diets may benefit children with epilepsies who have not responded to several different seizure medicines, children who aren't surgical candidates due to the location of the seizure focus or other factors, and children who have specific conditions including:

Lennox Gastaut syndrome
Infantile spasms (West syndrome)
Rett syndrome
Tuberous sclerosis complex
Dravet syndrome
Doose syndrome
GLUT-1 deficiency

These types of diets cause the body to burn fat for energy rather than relying solely on carbohydrates for energy. No one knows for sure why these diets are effective for some people with epilepsy. But studies show that up to two-thirds of children who follow one of these diets are helped by it. Some eventually may be able to decrease the dose of their anti-seizure medications or discontinue their medications altogether.

Dietitians at the Comprehensive Epilepsy Center have extensive experience in helping families who want to start a ketogenic or Modified Atkins Diet. They work closely with patients and families to create a meal plan that is as normal as possible so that kids can still enjoy eating and participate in special events, such as birthday parties.

Our team monitors children closely for possible side effects of the diets, such as constipation, and are available to answer questions and provide support over the long term.

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Ketogenic DietShow

This diet gets its name from the fact that people who follow it produce a high level of “ketones” in the body. Ketones are organic compounds that form when the body uses fat for its source of energy. They are not dangerous.

The ketogenic diet is very restrictive, and requires careful measuring to ensure that the child receives a precise balance of carbohydrate, protein, and fat grams with each meal. To begin the diet, children are admitted to Cincinnati Children’s for a three- to four-day inpatient stay. During this time, our team introduces the diet and monitors the child closely to see how their child’s body responds to the restrictive diet and make adjustments as needed.

Your family will have one-on-one education with the dietitian to make sure you and your child feel comfortable with all aspects of the diet prior to discharge. Children come to the clinic for follow-up appointments at the one-month mark, and then every three months after that.

Modified Atkins DietShow

A modified Atkins diet is less restrictive than the ketogenic diet. It does not require a hospital stay, but instead requires an outpatient visit with the dietitian. This diet does involve some blood tests prior to starting, as well as frequent monitoring and follow-up appointments.

Frequently Asked QuestionsShow

Will a specialized diet reduce my child’s seizures?

Unfortunately, it is not possible to predict whether a specialized diet will help reduce your child’s seizures.

The ketogenic diet often is effective for children with certain types of conditions that are associated with seizures, such as GLUT1 deficiency syndrome and pyruvate dehydrogenase deficiency. However, the diet also helps some children with other types of epilepsy. The child’s age or epilepsy type does not seem to affect whether the diet will be effective. Our care team will talk to you about whether a ketogenic diet might be a good option for your child.

Which diet should I consider?

Following either diet can be a big adjustment for families, so it is important for you to learn all you can before making the commitment. You will meet with the dietitian and discuss your child’s nutrition history and preferences prior to starting the diet. The dietitian will work with you to decide which diet will be the best fit for your child.

Can a ketogenic diet harm my child?

No, but the diets do require close monitoring with the dietitian and medical team. Ketogenic and modified Atkins diets can cause minor issues, such as constipation and kidney stones, but these are avoidable.

Is a ketogenic diet forever?

In most cases, children remain on the diet for two to three years, if it is effective. Eventually, we may recommend introducing regular food into your child’s diet to see if the seizures recur. If the diet is not effective within a few months, it will be stopped.

How long until we see results?

Often, a period of fine-tuning is needed to determine whether a ketogenic or modified Atkins diet will be effective in helping a child achieve seizure control. After three to six months, our team will evaluate how well the diet is working. If your child is experiencing an improvement in his or her seizure frequency, we may reduce his or her anti-seizure medication at this time.