Other non-pharmacological management Flashcards
What is the ketogenic diet?
The “classic” ketogenic diet is a special high-fat, low-carbohydrate diet that helps to control seizures in some people with epilepsy.
Due to the low carbohydrate intake it mimics the state of starvation in the brain, forcing the body to breakdown fat instead of carbohydrates, leading to the release of ketones.
Ketones have shown to have anti-convulsant properties.
Who initiates the ketogenic diet?
It is only initiated in tertiary care under Epilepsy specialists.
Is the ketogenic diet recommended for all epileptics?
No only for patient’s with difficult to treat epilepsy (entractable epilepsy) when AEDs are not effective and for certain epilepsy syndromes.
It is often used in children whose seizures do not respond to AEDs.
Describe the classic ketogenic diet.
Classic ketogenic diet:
Fat in the diet provides – around 90 per cent of calories and mostly comes from foods naturally high in fat, like double cream, butter, oil and avocado.
Carbohydrates are very limited.
Diet is lower in protein than a normal diet, but provides enough for growth
All foods are weighed for everything eaten on the diet
Describe the modified ketogenic diet.
Modified ketogenic diet:
High in fat with limited carbohydrate and unlimited protein.
Carbohydrates are weighed and fat is provided in household measures (e.g. 1tbsp double cream).
Protein foods do not need to be weighed
Describe the medium chained TG diet.
More generous intake of protein and carbohydrate.
Diet contains some fat which occurs naturally in food, as well as supplements of MCT fat.
Prescribed supplements will include: MCT oil and Liquigen®.
All foods are weighed for everything eaten on the diet
What should patients regarding driving if they have a seizure?
Must inform the DVLA immediately if they have an epileptic seizure or blackouts and to stop driving immediately.
This can be reported online or by filling in the FEP1 form and sending it to the DVLA.
DEPV1 for bus, coach or lorry license.
Depending on the type of seizure it may be taken away, and you can reapply after a certain period of time since your last seizure. Bus, coach and lorry licenses tend to have tougher regulations.
What happens to patients if they don’t report it and continue driving?
Could be fined up to £1000 if they don’t and an accident occurs as a result of a seizure.
