Tackling epilepsy one bite at a time
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Cape Town - Keilah Hall was nearly 14 months old when her seizures started. The first was a grand mal seizure, which affects the entire brain. It lasted 10 minutes. When it stopped, she closed her eyes and went limp.
Her mother, Belinda Hall, says that when the little girl eventually started crying, it was the best sound in the world.
The following week Keilah started having head-dropping seizures. These caused her to drop to the ground and bump her head. Keilah’s seizures went from three a day to over 100 within a week and she was eventually put on anti-epileptic drugs, which initially made her seizures worse.
“She wouldn’t know what had happened. It was awful, and I didn’t want her to go through this,” says Hall.
Keilah was subsequently diagnosed with myoclonic astatic epilepsy syndrome.
Paediatric dietitian Kath Megaw suggested a ketogenic diet.
Keilah, who is also allergic to egg whites, had been her patient since the age of 10 months.
Six weeks after experiencing her first seizures, Keilah was weaned off the anti-epileptic drug and started the ketogenic diet on May 21, 2011.
As Keilah was still transitioning to solid foods, Hall says a typical meal consisted of gem squash, cheese, cream and biltong powder. The diet and portions were tailor-made for Keilah and within a week the frequency of seizures had decreased.
Her doctor then started her on a different anti-epileptic drug, and the combination of the diet and new medication saw the frequency and intensity of the seizures dramatically reduce.
Keilah, who is now three, was weaned off the diet in December and is still taking the anti-epileptic drug. She has been seizure free since August 3 last year.
To share Keilah’s good fortune and the medical knowledge, Hall together with her husband Ray, Megaw, neurologist Dr James Butler, and epitiologist Dr Birgit Schlegal, launched the Keilah Foundation recently.
The foundation aims to create awareness and increase dietary assistance, including the ketogenic diet, to children with special needs.
Studies have shown that the earlier the diet is initiated at the onset of the seizure symptoms, the greater the chance of seizure control. While progress varies from patient to patient, an improvement can be seen within the first three months.
According to the foundation, the ketogenic diet was first mentioned by Hippocrates in 500 BC. He noted that patients stopped having seizures when they were starved of food.
Today doctors are able to mimic the state of starvation through the ketogenic diet. It is high in fat, has sufficient protein for growth and has no or low carbohydrates and starches.
Megaw says the diet includes healthy fats such as avocado, creams, olive oil, coconut oil, nuts, and seeds, as well as a range of protein foods such as chicken, fish, and meat. Bread, pasta, rice and cereals are not initially included in the diet.
The foundation says that the body uses sugar as the preferred source of energy. However, it will use fat for energy in the absence of starch and sugars.
When the body is forced to break down the fat, it makes ketone bodies, which the brain can use as its alternative energy source. This changes the brain’s metabolism and interrupts seizure pathways.
The foundation says that a good multivitamin is needed when using this diet.
Both Epilepsy SA and the Keilah Foundation caution that this is a medical treatment and must be done under strict medical supervision by a neurologist and a trained ketogenic dietitian.
Megaw has been initiating the diet in families for the past 15 years, and she and her team have assisted over 100 families in South Africa and parts of Africa.
Mark van der Heever, the provincial health department spokesman, says the ketogenic diet has been in use as a treatment for epilepsy since 1921 and “remains a valuable therapeutic approach for management of refractory epilepsy, especially in children if used under the direct and close supervision of a specialist physician and the dietitian”.
He adds that the diet is most effective in children younger than 10 years, with a peak efficacy among children aged 2 to 5.
Van der Heever cautions that children younger than a year are likely to become hypoglycaemic if on the diet.
Hall is grateful for the change she sees in her daughter.
“Every day I thank the Lord that she didn’t have a seizure. It’s made a huge difference in her life,” she says.
Hall says that since the seizures stopped, Keilah has become more confident, she dances and runs around and she is able to concentrate for longer.
“I can see how her quality of life has changed, and it’s amazing.” - Cape Argus
* One in 100 South Africans has epilepsy.
* Slightly more men than women have epilepsy.
* 75 percent of people with epilepsy have their first seizure before the age of 20.
* Up to 80 percent have their conditions controlled by medication.
* In about 66 percent of cases, the underlying cause of epilepsy is unknown.
* Seizures can last for a few seconds to a few minutes. – Information supplied by Epilepsy SA