Epilepsy and a Ketogenic Diet: Facts and Research

Updated on December 13, 2017
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Linda Crampton is a writer and teacher with a first class honors degree in biology. She often writes about the scientific basis of disease.

Brain anatomy
Brain anatomy | Source

Epilepsy and Diet

Epilepsy is a disorder involving periods of abnormal electrical activity in the brain. The neurons in the brain transmit an electrical signal in order to perform their job. They're often said to "fire" as they do this. During a seizure, the neurons in a particular area fire at the same time, resulting in an intense burst of electrical activity. The disturbance causes a person to experience unusual sensory, motor (movement), or mental events.

Epilepsy can sometimes seriously interfere with life. Drugs, surgical techniques, and special diets are used to control the disorder. The ketogenic diet is very helpful for some people. The diet is high in fat and low in carbohydrates. It's described as potentially beneficial for patients by both medical organizations and epilepsy associations. Recent research supports the idea that the diet can be beneficial.

What Is Epilepsy?

Please note that this article is intended for general interest only. Anyone who has questions about epilepsy treatment or who wants to follow a non-traditional diet in an attempt to help a medical condition should seek a doctor's advice.

Treatment With Medication or Vagus Nerve Stimulation

Epilepsy can be a relatively minor condition involving seizures that are successfully controlled with medication. My father had the condition. Once he was diagnosed, his medication worked well. There are many drugs available for a patient to try. If one drug doesn't work, another may.

Some patients have a severe form of epilepsy that involves frequent seizures and doesn't respond to medication. Surgery may be used as a treatment for these patients. One type of epilepsy surgery is known as vagus nerve stimulation, or VNS.

The vagus nerve travels from the brain to the abdomen. Branches extend from the nerve to various parts of the body. In VNS, a small device resembling a pacemaker is placed under the skin in the upper part of the chest. A wire extends from the device to the vagus nerve in the neck. The device sends regular electrical pulses through the wire and nerve to the brain, which interferes with the creation of a seizure. The patient can use a magnet to trigger a burst of pulses when they sense that a seizure is approaching.

VNS helps some patients, but it isn't effective for everyone who tries it. Scientists don't know how the process prevents seizures. It may disrupt the abnormal electrical signals in the brain in some way. Another theory is that it stimulates the creation of chemicals that interfere with the signals.

Nerves consist of neurons, or nerve cells. The signal that's transmitted along a neuron is sometimes known as a nerve impulse.

The dendrites of a neuron receive the nerve impulse and transmit it along the axon.
The dendrites of a neuron receive the nerve impulse and transmit it along the axon. | Source

Treatment With a Corpus Callostomy

The cerebrum is the largest part of the brain. It has a convoluted surface and consists of the right and left cerebral hemisphere. The hemispheres are separated by a groove known as the longitudinal fissure. The separation isn't complete, however. The corpus callosum is a band of nerve fibres that connects the two cerebral hemispheres. It passes messages from one side of the cerebrum to the other. A much smaller band of nerve fibres called the anterior commissure also connects one hemisphere to the other.

One type of surgery used to control severe epilepsy is known as a corpus callostomy. The corpus callosum is partially or completely cut during the surgery. This prevents electrical disturbances from travelling from one side of the cerebrum to the other. As a result, the severity of the patient's seizures is reduced. The seizures aren't eliminated, however, because an electrical disturbance can be generated in a single hemisphere.

Although separating the two hemispheres of the brain shouldn't be taken lightly, it may have fewer consequences than some people imagine. It's sometimes hard to tell that a major connection between the hemispheres has been severed unless special tests are performed. In other cases, it may be more obvious that certain brain functions have been lost.

The corpus callosum in the brain
The corpus callosum in the brain | Source

The corpus callosum is coloured green in the illustration above. The anterior commissure is represented by the white oval structure just underneath the corpus callosum.

The Ketogenic Diet for Epilepsy

Ever since the 1920s, the ketogenic diet has been recognized as a helpful treatment for some people with epilepsy. The idea is mainstream today. The diet is also used to help people with diabetes. It's high in fat, low in carbohydrates, and adequate in protein. It's described in terms of the ratio of fat to carbohydrate plus protein. A 3:1 diet contains three grams of fat for every one gram of carbohydrate plus protein, for example. A 4:1 diet contains four grams of fat for every gram of carbohydrate plus protein.

Although slightly different forms of the diet exists, it generally includes:

  • meat
  • fish
  • eggs
  • hard cheese and plain yogurt
  • most vegetables
  • a few legumes or products made from them (including tofu)
  • berries and a few other fruits
  • nuts
  • large amounts of animal fat and plant oil

All grains, the starchiest vegetables and legumes, and the sweetest fruits are prohibited.

Medical Supervision

Anyone following a ketogenic diet in an effort to relieve epilepsy must be under a doctor’s supervision. There are several reasons for this, as described below:

  • The diet is challenging to follow correctly. A large amount of fat must be eaten on a regular basis in order to prevent seizures.
  • Food must be weighed before it's consumed. Training and practice may be needed in order to do this correctly.
  • The diet lacks certain nutrients, as least in the version used to treat epilepsy. The missing nutrients must be provided by supplementation.
  • Doctors must discover the proportion of fat to other nutrients that is most beneficial for the patient.
  • The introduction and initial effects of the diet must be monitored. The diet is generally started while the patient is in hospital.

Eggs and herbs are included in the ketogenic diet.
Eggs and herbs are included in the ketogenic diet. | Source

Potential Problems

Patients may experience side effects from the ketogenic diet, especially if they follow it for a long time. These effects may include constipation, acidosis (excessively acidic body fluids), kidney stones, and an increased risk of bone fractures. Some of the side effects may require medical treatment.

Another potential problem with the diet is it often contains a high level of saturated fats. Many health experts and agencies consider these to be unhealthy when eaten in excess. This fact is probably unimportant for someone who has been experiencing many seizures a day and finds that the diet reduces their frequency, though. In addition, since researchers don't completely understand why the diet can be helpful, it's possible that the saturated fats—or specific fatty acids found in the fats—are responsible for the benefit.

Dietary Therapy for Epilepsy

Ketone Bodies and Ketosis

The body's preferred source of energy is carbohydrate molecules. When these are unavailable during fasting or in a diet low in carbohydrate, the body obtains energy by breaking down fatty acids. These are obtained from the fat molecules stored in the body or from the food that's eaten. Ketone bodies are produced during the process. These molecules include beta-hydroxybutyrate, acetoacetate, and acetone. The production of ketone bodies is known as ketosis.

Fasting helps to improve epilepsy in some people, as even people in Ancient Greece noticed. It's obviously not practical to fast for a long time, since we need food to survive. Since both fasting and the ketogenic diet increase the level of ketone bodies in the blood, scientists have assumed that both methods help epilepsy by the same method. This may not be the case, however. Research in mice suggests that fasting and the ketogenic diet work by different mechanisms.

Researchers don't know whether the ketone bodies produced in the ketogenic diet, the low carbohydrate intake, or another factor is responsible for the benefit observed in epilepsy. The ketone bodies alter the way in which the brain obtains energy, but this isn't necessarily the reason for the diet's benefit. It's wonderful that the eating plan is helpful for some people, but it would even better to help more people and to help patients to a larger extent. Hopefully researchers will soon discover how the diet works as well as how to improve its effectiveness.

Avocados are rich in monounsaturated fatty acids.
Avocados are rich in monounsaturated fatty acids. | Source

A Ketogenic Diet Plus Fasting

In 2012, researchers at the John Hopkins Children's Center discovered that children who were benefitting from a ketogenic diet experienced even fewer seizures when they fasted every other day for a short period of time. Four of the six children involved in the study experienced between fifty and ninety-nine percent fewer seizures after fasting was added to their regimen. Further research is necessary, however, due to the small number of children in the study. It's vital that a doctor is consulted before any form of fasting is started in a person with epilepsy.

Effects of Diet on Seizures: Some Recent Research

Research confirms observations about the benefits of the ketogenic diet for epilepsy. Two recent projects support the idea. The first was led by a doctor at Dell Children's Medical Center of Central Texas. It involved 210 children whose epilepsy was resistant to drug treatment. The children were divided into groups as follows:

  • 150 children were treated with vagus nerve stimulation.
  • 44 had corpus callostomy surgery.
  • 98 followed a ketogenic diet.

A "successful" treatment was defined as one that caused a 50% or greater reduction in seizures. The percentages of children who experienced success after receiving a specific treatment were as follows:

  • 52% of the children given VNS
  • 54% of those who underwent a corpus callostomy
  • 63% of those who followed the ketogenic diet

Although it would be nice if the percentages were higher, the results of the study are significant and impressive.

Full-fat cheese is part of the ketogenic diet.
Full-fat cheese is part of the ketogenic diet. | Source

Another Research Project

The second study was performed by a researcher at McMaster University in Canada. Like the first one, it was described at a meeting of the American Epilepsy Society in December, 2017. The results of the study haven't yet been published in a scientific journal.

The study involved forty children and teens up to the age of seventeen. The goal of the research was to discover whether a ketogenic diet that was more lenient than usual could still be helpful for patients.

The initial diet contained a lower percentage of fat than the traditional ketogenic one and was started when the subjects were outpatients at a hospital. If seizures weren't controlled, the ratio of fat in the diet was increased at two to three week intervals. Unfortunately, more specific details about the different fat ratios and the timing of their introduction aren't yet available to the general public.

As a result of the study, the researcher found that "about half" of the children had a greater than fifty percent reduction in seizures even while following a lower fat content than usual. In seven children, seizures completely stopped.

Berries and cream are allowed in a ketogenic diet.
Berries and cream are allowed in a ketogenic diet. | Source

Variations of the Ketogenic Diet

Research exploring the link between the ketogenic diet and epilepsy is usually performed in children. Adults with epilepsy may also benefit from a high fat diet. In the case of adults, the diet that's explored is generally the modified Atkins diet. The Atkins diet is a low-carbohydrate eating plan created by a cardiologist. The modified diet is high in fat as well as low in carbohydrate. It's easier to follow than the ketogenic diet and doesn't require a hospital stay at the start.

As the quote below shows, the modified Atkins diet has about a fifty percent success rate in adults, with "success" meaning a significantly lowered rate of seizures. John Hopkins Medicine has also explored the use of the ketogenic diet in adults with a severe form of drug-resistant epilepsy. The researchers say that about a third of the patients benefitted from the diet.

The MCT oil diet (or MCT diet) is another variation of the ketogenic diet that has been used to help people with epilepsy. MCT stands for medium-chain triglycerides. Coconut oil is a good source of these chemicals and is the main fat in the diet. According to the University of Toronto's Hospital for Sick Kids, the diet has about the same percentage of success as a classic ketogenic diet.

Recent studies have shown that the modified Atkins diet lowers seizure rates in nearly half of adults that try it, usually within a few months.

— John Hopkins Medicine

Food and Epilepsy

It's certainly seems worthwhile for people without adequate control of their epilepsy symptoms to try dietary therapy (with a doctor's recommendation and guidance). There is some concern about health problems that may result from the intake of foods high in fat over a long period. Researchers are also investigating whether a high-fat diet must be a permanent or long-term eating plan or whether it can be eventually dropped. Hopefully these questions will be answered in the future. In the present, though, the ketogenic diet or a similar eating plan may be very helpful for some people with epilepsy.


  • Epilepsy facts from the Mayo Clinic
  • Facts about vagus nerve stimulation from the AANS (American Association of Neurological Surgeons)
  • Corpus callostomy information from WebMD
  • Information about the ketogenic diet for epilepsy from WebMD
  • Diet may help epilepsy in children when medications fail from the Medical Xpress news site
  • Ketogenic diet information from the Epilepsy Foundation (This website also has information about the modified Atkins diet.)
  • Information about the MCT diet for epilepsy from The Hospital for Sick Children (This hospital is affiliated with the University of Toronto Faculty of Medicine.)
  • Adult epilepsy and facts about the modified Atkins diet from John Hopkins Medicine
  • Johns Hopkins Medicine. "Fasting may benefit patients with epilepsy." ScienceDaily. www.sciencedaily.com/releases/2012/12/121206203122.htm (accessed December 12, 2017).

© 2017 Linda Crampton


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    • AliciaC profile image

      Linda Crampton 7 weeks ago from British Columbia, Canada

      Thanks for the comment, Audrey. I hope your sister continues to stay free of seizures.

    • vocalcoach profile image

      Audrey Hunt 7 weeks ago from Idyllwild Ca.


      My sister has suffered with epilepsy for years. She hasn't had a seizure since being prescribed a new medication. I'm all for going with dietary therapy. This is so interesting. I've learned a lot through reading this informative article. Big thanks!

    • AliciaC profile image

      Linda Crampton 2 months ago from British Columbia, Canada

      Hi, Natalie. I was surprised by the research that I read about the effects of separating the two hemispheres. It's a very interesting topic!

    • Natalie Frank profile image

      Natalie Frank 2 months ago from Chicago, IL

      Interesting article. I always thought severing the corpus collosum would result in problems initially due to the failure of the two hemispheres to communicate but later each was able to compensate due to plasticity. Thanks for all the info!

    • AliciaC profile image

      Linda Crampton 2 months ago from British Columbia, Canada

      Hi, Michelle. It would certainly be interesting to learn more about the behaviour of ketone bodies! Thanks for the comment.

    • Michelle Dalson profile image

      Michelle Dalson 2 months ago

      Great article. Learning about fatty acid metabolism and ketogenesis was one of my favorite parts about biochemistry. Makes me wonder how researchers can test what the ketone bodies are doing in the brain.

    • AliciaC profile image

      Linda Crampton 2 months ago from British Columbia, Canada

      Hi, Peggy. Yes, I hope the effects of the diet are monitored if someone needs to follow it for a long time. It will be interesting to read about the discoveries.

    • Peggy W profile image

      Peggy Woods 2 months ago from Houston, Texas

      What an interesting subject for people who have epilepsy and/or diabetes. Hopefully researchers will determine the long term effects of these ketogenic diets in order to discover their safety. This is the first that I had heard that they might be effective in treating those conditions. The statistics are pretty impressive.

    • AliciaC profile image

      Linda Crampton 2 months ago from British Columbia, Canada

      Thank you, Genna. We seem to have a lot to learn about the benefits of different diets. It's an interesting topic!

    • Genna East profile image

      Genna East 2 months ago from Massachusetts, USA

      What an interesting article -- I was especially surprised to learn about the ketogenic diet, and the amount of fats needed in the daily regimen. No wonder the Atkins has this rate of success. Well written, Linda, as always.

    • AliciaC profile image

      Linda Crampton 2 months ago from British Columbia, Canada

      Hi, Dianna. Thanks for commenting. I hope your aunt's epilepsy is under control.

    • teaches12345 profile image

      Dianna Mendez 2 months ago

      I have an aunt with epilepsy. This has educated me on how much a diet can help with this disease. Thank you for the information.

    • AliciaC profile image

      Linda Crampton 2 months ago from British Columbia, Canada

      Thanks for the visit, Kate. The effects of the ketogenic diet are interesting to explore, especially in relation to disease.

    • Wolfy profile image

      Kate Daily 2 months ago from California

      Very informative article Linda! I am especially interested to learn more about the Ketogenic Diet... epilepsy can be such a scary thing. I've had a close personal friend that suffered from this for a long time before she passed. Luckily modern day treatments can do a lot to help!

    • AliciaC profile image

      Linda Crampton 2 months ago from British Columbia, Canada

      I appreciate your visit and comment, Nithya. I think the fact that a specialized diet can sometimes help epilepsy is impressive.

    • Vellur profile image

      Nithya Venkat 2 months ago from Dubai

      Interesting and informative article about epilepsy and ketogenic diet. It is amazing to note that a diet change can help treat an illness. Thank you for sharing so many facts along with the information about the research that was done.

    • AliciaC profile image

      Linda Crampton 2 months ago from British Columbia, Canada

      Hi, Kari. Yes, it's both amazing and wonderful when changing the diet solves a health problem! I wish a change could help everyone with a disease.

    • k@ri profile image

      Kari Poulsen 2 months ago from Ohio

      This is a very interesting article. It is amazing that something as small as changing your diet can have such a large effect on your life.

    • AliciaC profile image

      Linda Crampton 3 months ago from British Columbia, Canada

      I'm glad your mother's tumor was benign, Nell. Thanks for the visit and the comment.

    • AliciaC profile image

      Linda Crampton 3 months ago from British Columbia, Canada

      Thanks, Nikki. Best wishes to you.

    • Nell Rose profile image

      Nell Rose 3 months ago from England

      My mother had a form of epilepsy caused by a benign brain tumor, it was a scary thing to see. Great information for anybody suffering from this illness.

    • nikkikhan10 profile image

      Nikki Khan 3 months ago from London

      Ohh okay,,I did tell my sister about diet which can control the sizures,, but as you are saying will ask her to consult with their doctor first before starting any diet plan.

      Thanks for the advice dear.

      God Bless you.

    • AliciaC profile image

      Linda Crampton 3 months ago from British Columbia, Canada

      Thanks, Devika. It's wonderful when diet does help someone with a disease. I wish food was always helpful.

    • profile image

      DDE 3 months ago

      Important and interesting information. In such cases such diets don't always work for everyone.

    • AliciaC profile image

      Linda Crampton 3 months ago from British Columbia, Canada

      I'm sorry that your family is experiencing epilepsy, Nikki. It's important that they consult a doctor before they start the diet. It may be helpful for them, but it doesn't help everyone who tries it.

    • nikkikhan10 profile image

      Nikki Khan 3 months ago from London

      Hi Linda,very interesting article, sadly I saw the first one with this attack was my elder sister.She is been taking medication her whole night and still is taking.Now it's transferred to her youngest daughter,she just had her first electric shock just two months ago which shocked us all.

      I didn't know, it can be controlled through diet. I will tell my sister about this diet,may be this would help a bit.

      Many thanks for sharing this information.

      Bless you.

    • AliciaC profile image

      Linda Crampton 3 months ago from British Columbia, Canada

      Hi, Dora. Yes, it must be challenging. I hope better treatments are found for the disorder or that the treatments that exist are improved.

    • MsDora profile image

      Dora Weithers 3 months ago from The Caribbean

      It must be quite a challenge to lead a somewhat normal life with the possibility of epileptic seizures. Thanks for making us aware of these difficulties some endure. Situations like these inspire gratitude and compassion.

    • AliciaC profile image

      Linda Crampton 3 months ago from British Columbia, Canada

      Thanks for the comment and for sharing the information, Heidi. I hope your dog never experiences a serious seizure problem.

    • heidithorne profile image

      Heidi Thorne 3 months ago from Chicago Area

      I remember a girl in grade school who had it. Her seizures were very scary to observe!

      My dog also has occasional seizures, though the vet has ruled out epilepsy. But I guess it can be similarly serious in young pets, too.

      Always interesting and well researched info, Linda! Thanks for sharing your insight with us.

    • AliciaC profile image

      Linda Crampton 3 months ago from British Columbia, Canada

      Hi, Bill. Yes, a seizure can be scary to see when someone hasn't experienced it before. It can sometimes be a dramatic event, though I've also seen it take a minor form in one of my students. Thanks for the visit.

    • billybuc profile image

      Bill Holland 3 months ago from Olympia, WA

      I was thirteen the first time I saw someone have an epileptic attack. Scared the heck out of me, the scariest thing I had ever seen. That kid and I became friends. I wonder what happened to him. Oh well, great information, Linda.

    • AliciaC profile image

      Linda Crampton 3 months ago from British Columbia, Canada

      Thanks for sharing the interesting information about autism, Sudipa.

    • hiya-writer profile image

      Sudipa 3 months ago from India

      Full fat cheese is a part of diet, but I have seen my sister keep away milk products from my nephew. He is a 11 year old child with autism. Autistic kids are known to be at a higher risk of epilepsy.

    • AliciaC profile image

      Linda Crampton 3 months ago from British Columbia, Canada

      Hi, Flourish. I think it would be wonderful to use diet to enhance disease treatment. It does make sense that our diet can affect the severity of illnesses. Thanks for the comment.

    • FlourishAnyway profile image

      FlourishAnyway 3 months ago from USA

      This is very thoroughly researched and enlightening as all of your articles are. It certainly makes sense that diet can impact the severity of disease symptoms. I see a future in which we better manage a range of major illnesses using diet as a major complement to traditional approaches.

    • AliciaC profile image

      Linda Crampton 3 months ago from British Columbia, Canada

      Thank you very much for the comment, Jackie. It's good that we have improved medical treatments today so that more people can survive illnesses. We still need cures for some serious diseases, though. It would be nice if people didn't have to fast in order to get better!

    • Jackie Lynnley profile image

      Jackie Lynnley 3 months ago from The Beautiful South

      This was so very interesting Linda. Seems the diet is most important (added that it benefits diabetes too is great) and it appears this has been a historic study! But people made it without medicine since the beginning of time, haven't they? I am sure though many are thankful for the chemical and surgical helps to live a better life.

      I wonder about about children fasting every other day? That must be very hard to do as a child but even there I am sure the child would do what they can to omit the horrors of seizures.

      Again, extremely interesting and well done.

    • AliciaC profile image

      Linda Crampton 3 months ago from British Columbia, Canada

      Thanks for the interesting comment, Manatita. I appreciate your visit and kindness, as I always do. I think the ketogenic diet could be criticized in multiple ways if it's followed by someone without a specific health problem. It's wonderful that it it helps some people with epilepsy, though. I hope researchers discover more about its effects soon.

    • manatita44 profile image

      manatita44 3 months ago from london

      Of very educational and nursing value is this Hub. Perhaps you can write one of Diabetes, highlighting the hypoglycaemic and hyperglycaemic coma's and their effects on the organs over a period of time.

      Back to your diet. A great many American naturopaths are now saying that this kind of diet is too acidic. There is a lot of emphasis on alkaline foods: Fruits, berries, melons and some vegetables. What are your thoughts here. Look up Dr Morse. Another brilliant Hub!