Epilepsy
What is Epilepsy?
Epilepsy is a neurological condition, often called ‘seizure disorder’, that results in unprovoked seizures. [1]
Diagnosing seizures and epilepsy is like putting the pieces of a puzzle together and requires information from many different people and many different tests.
Simply stated, epilepsy is diagnosed when an individual has experienced 2 or more seizures.
The normal change in brain activity that occurs during a seizure can be measured and diagnosed with an Electroencephalogram (EEG). [2]
When EEG testing, clinical history, family history, and outlook are similar amongst a group of people, they can be classified into a specific epilepsy syndrome, a few examples include:[2]
Childhood absence epilepsy, benign rolandic epilepsy, Doose syndrome, Dravet syndrome, early myoclonic encephalopathy, Jeavons syndrome, FIRES, and West syndrome.
What are Seizures?
A seizure is a brief change in normal brain activity. [1]
A seizure can last anywhere from a couple of seconds to a few minutes.
Sometimes it is difficult to tell if a person is having a seizure because they may just appear confused, blink rapidly, or seem to be in a blank stare.
This may be an absence seizure
On the other hand, seizures can display themselves as shaking, falling, and losing awareness.
This may be a tonic-clonic seizure
A person with epilepsy can have more than one type of seizure. Different types of seizures include: [1]
Generalized seizures
Absence seizures
Tonic-clonic seizures
Focal seizures
Simple focal seizures
Complex focal seizures
Secondary generalized
Seizure Triggers
A specific time of day
Sleep Deprivation
Elevated Fever
Flashing Lights
Stress
Poor Diet
Low Blood Sugar
Specific Foods
Hormonal changes
Signs & Symptoms
The main sign and symptoms of epilepsy are recurrent seizures. These signs and symptoms are indicators that an individual may be experiencing a seizure.
Blank staring
Rapid blinking
Muscle jerks or spasms
Shaking or falling
Loss of consciousness
Contributing Factors
Neurological diseases (such as autism)
Genetic disorders (such as Down Syndrome)
Family history
Traumatic brain injury
Brain infection
Loss of oxygen to the brain
Next Steps
Diet
Have a well-balanced diet and eat at consistent times to avoid long periods without food or skipping meals
Analyze potential food sensitivities and allergies, it is potential that the reactions to certain foods could trigger seizures. Avoid any foods or drinks that may aggravate seizures.
Consider an elimination diet if you suspect that certain foods may be triggering seizures.
Use a food journal to track foods and beverages consumed as well as to track signs and symptoms of seizures. Keeping a record of these items may help to determine a pattern between seizures and food triggers.
The Ketogenic Diet is a high fat, moderate protein, low carbohydrate diet that was developed for the treatment of pediatric epilepsy in 1920. It has recently emerged as a potential treatment for autism and may offer improvements to cognition, social skills, and some behaviors.
One scientific review concluded that children that effectively followed the ketogenic diet saw a 50% or greater reduction in the number of occurrences of seizures as compared to children that did not follow the diet. [5]
Supplements
Medium Chain Triglyceride (MCT) is a high-fat supplement that is easily converted into ketones. Ketones are an alternate fuel source that can be readily used as fuel by the brain and have been shown to be beneficial in patients with epilepsy. Particularly when used as part of the MCT Ketogenic diet. [2]
Lifestyle
Create routines around mealtime, activities, bedtime, and medication schedules. See the sleep note to learn more about bedtime routines.
If noises trigger seizures:
Try using earplugs, earphones, or listening to relaxing music in loud environments
If lights trigger seizures:
Try tinted or polarized glasses, open the blinds for natural light when inside instead of turning lights on, and focus on distant objects when riding in cars
Some seizures may occur cyclically signaling a hormonal factor, track seizure timing to determine a pattern. Modify lifestyle and minimize triggers during high-risk periods of time.
Encourage regular exercise and hydration.
Source: Autism Dietitian Instagram
DISCLAIMER: Before starting any supplement or medication, always consult with your healthcare provider to ensure it is a good fit for your child. Dosage can vary based on age, weight, gender, and current diet.
Epilepsy & Autism in the Research
Prevalence of Epilepsy
The prevalence of epilepsy in individuals with autism was found to be 12.1% while the prevalence of autism in individuals with epilepsy was 9.0%. [3]
This co-occurrence of epilepsy and autism shows that individuals with a single diagnosis of either should be tested. [3]
In summary, there is a higher chance for individuals with autism to also have epilepsy. [3]
Autism & Epilepsy
The link between epilepsy and autism is best observed when taking a look at socialization, behaviors, and epilepsy. [4]
Children with early-onset seizures are at the greatest risk of developing autism, particularly those children with infantile spasms. [4]
On the other hand, children with autism that have been diagnosed with intellectual disability are at the highest risk for developing epilepsy. [4]
The prevalence of seizures in children with autism increases with age. [4]
Early recognition of social deficits in children with epilepsy is important so that early intervention and development of a comprehensive treatment plan can take place. [4]
Early recognition and intervention are key in minimizing social-cognitive deficits
Ketogenic Diet & Epilepsy
The ketogenic diet has been shown to be effective as a diet treatment therapy for drug-resistance epilepsy.
One review concluded that children that effectively followed the ketogenic diet saw a 50% or greater reduction in the number of occurrences of seizures as compared to children that did not follow the diet. [5]
There was a 3x greater probability that children following the diet would gain freedom from seizures. [5]
It is important to note that many of the study participants dropped out due to how difficult it was to follow the diet. [5]
More research is needed to establish a particular introduction protocol to reach ketosis.
MCT Oil and Epilepsy
A child with autism and epilepsy who, after limited response to other interventions following her regression into autism, was placed on a gluten-free, casein-free ketogenic diet using MCT oil as its major fat source, and showed marked improvement in autistic and medical symptoms. [6]
Many patients with epilepsy who are not appropriate for CKD or modified Atkins diet or low glycemic index treatment will benefit from a modified ketogenic diet with MCT oil. [7]
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[1] About Epilepsy. Centers for Disease Control and Prevention. https://www.cdc.gov/epilepsy/about/index.htm. Published September 30, 2020. Accessed March 30, 2021.
[2] About Epilepsy: The Basics. Epilepsy Foundation. https://www.epilepsy.com/learn/about-epilepsy-basics. Accessed March 30, 2021.
[3] Lukmanji S, Manji SA, Kadhim S, et al. The co-occurrence of epilepsy and autism: A systematic review. Epilepsy Behav. 2019;98(Pt A):238-248. doi:10.1016/j.yebeh.2019.07.037
[4] Tuchman R. What is the Relationship Between Autism Spectrum Disorders and Epilepsy?. Semin Pediatr Neurol. 2017;24(4):292-300. doi:10.1016/j.spen.2017.10.004
[5] D'Andrea Meira I, Romão TT, Pires do Prado HJ, Krüger LT, Pires MEP, da Conceição PO. Ketogenic Diet and Epilepsy: What We Know So Far. Front Neurosci. 2019;13:5. Published 2019 Jan 29. doi:10.3389/fnins.2019.00005
[6] Herbert MR, Buckley JA. Autism and dietary therapy: case report and review of the literature. J Child Neurol. 2013;28(8):975-82
[7] Liu YM, Wang HS. Medium-chain triglyceride ketogenic diet, an effective treatment for drug-resistant epilepsy and a comparison with other ketogenic diets. Biomed J. 2013;36(1):9-15.
Authors
Edited and Reviewed by: Brittyn Coleman, MS, RDN/LD, CLT
Sinead Adedipe, MS, RDN
