Ketogenic diet: Dietary therapy for epilepsy and migraines

A ketogenic diet is a very low-carb, high-fat diet. This reduction in carbs puts your body into a metabolic state called ketosis, which burns fat and provides energy to the brain. This has been linked to reducing the number of seizures in some patients with epilepsy.

If medicine does not control your seizures or migraines, a special diet may work. A very low-carb, high-fat ketogenic diet forces your body to use fat for energy instead of carbs.

Studies show that 50 percent of patients who eat a ketogenic diet see a 50 percent or greater reduction in seizures. Some people report having less frequent or less severe migraines while on a ketogenic diet.

A healthy keto diet is built on whole, nutrient-dense foods, such as meat, fish, eggs, nuts, seeds, non-starchy vegetables, berries, avocados and healthy fats. Avoid bread, pasta, rice, cereal, potatoes and sugary sweets such as candy, cookies and cakes.

Many of your appointments and sessions with the care team can be done via video visits.

• You will meet with a neurologist and dietitian to learn more and decide if diet therapy is right for you.

• If you would like to try diet therapy, you will have labs drawn and fill out a three-day food record.

• You will meet with the dietitian for an education session. We provide resources, recipes and books to help you succeed.

• You will meet with your doctor and dietitian one month after starting the diet and about every three months while on the diet.

• Routine labs are typically checked every three to six months. Sometimes labs are checked more often for specific situations.

You might see benefits right away, or it might take a couple months. We advise trying the diet for three months. If it is not helpful and/or not compatible with your lifestyle, the diet can be weaned after three months.

Patients who follow a medical ketogenic diet will work with our Adult Neurology Ketogenic Diet Therapy Clinic. Patients will be provided with nutrition information, meal planning resources, recipes and will be closely monitored by our providers.

We also offer quarterly ketogenic cooking classes for our patients. Held in the Learning Kitchen at East Madison Hospital, these classes provide an opportunity to work with ketogenic-friendly ingredients, test new recipes, expand cooking skills and learn how to make keto friendly versions of their favorite dishes. Due to the COVID-19 pandemic, these classes are currently on hold. We hope to restart them in 2022.

The Adult Neurology Ketogenic Diet Therapy Clinic is made up of a team including neurologists (see profiles below) and

• Dieticians: Kelly Faltersack, MS, RDN, CD and Megan Grassl, MS, RDN, CD

• Pharmacist: Lisa Hawk, PharmD

• Nurse: Hailey Hicks, RN

Our clinic is located at University Hospital in Madison, and we also offer telemedicine and video visits for your convenience.