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I think we often forget the real purpose of food. Food is supposed to give us the energy we need to go about our days. Food is supposed to prevent illness and help us heal from disease or injury. Yet, the way that we often eat causes more harm than good. I’m reminded of a patient of mine. She has had epilepsy since she was a child. Now in her thirties, she’s had multiple epilepsy surgeries and has been on five to six different antiepileptic medications at the same time. And she still continued to have frequent seizures. I finally got her seizure-free by taking soda out of her diet. The way our patients eat has a significant impact on seizures. That’s why the ketogenic diet has been effective for seizure management in both children as well as adults. Historically, we’ve used it most frequently in children who are developmentally delayed, probably because they often can’t get up and grab some high carbohydrate meal and throw themselves out of ketosis and into status epilepticus. Following a ketogenic diet can be a challenge. The modified Atkins diet is a less restrictive alternative that may still provide some benefit for seizure control. But sometimes you don’t have to prescribe a complicated diet to help manage someone’s seizures. Even small changes to the way someone eats can have a significant impact on their seizure frequency. It’s not only what people eat that matters. It’s also what they drink. I’ve taken care of multiple people without a history of seizures who presented with seizures in the setting of drinking energy drinks. And we all know that alcohol is toxic to the entire body and especially the brain. I remember a patient that I once took care of. He had had a history of seizures, but only when he drank alcohol. He wasn’t on any antiepileptic medication. He was a successful professional with a loving, significant other and children to care for. It was his birthday, and despite knowing that alcohol triggered his seizures, he decided that since it was his birthday, he was going to have a lot of alcohol as a way to have fun and celebrate it. He presented to the ER in status epilepticus. He had been seizing nonstop for over an hour before he came into the ER. At that point, nothing we gave him worked and we were forced to intubate him and sedate him for over 24 hours. Oftentimes, the things that people put in their bodies – the things that they eat and drink – have a significant impact on their seizure frequency. So when you’re seeing someone with a history of epilepsy, make sure that you address diet as a way to help manage their seizures.
