While most neurological disorders have traditionally been treated with pharmacological agents, there is growing evidence that dietary interventions can also exert beneficial clinical effects comparable to, or perhaps exceeding, drug therapy. This is especially true for the epilepsies which respond favorably to a high-fat low-carbohydrate diet known as the ketogenic diet. Indeed, following historical observations that fasting was effective for seizure control, clinicians formulated the ketogenic diet in the 1920's to mirror the biochemical changes seen in the fasted state. And although the ketogenic diet has been available since then in medical centers throughout the United States, it was not until this past decade that widespread international acceptance of this non-pharmacological intervention as an effective treatment for medically refractory epilepsy had been achieved. Scientific interest in the ketogenic diet has also paralleled the growth of clinical centers throughout the world, with the goal of understanding its underlying mechanisms of action - important information that is necessary to improve upon its clinical implementation. In the past several years, variations of the ketogenic diet have emerged as efficacious and better tolerated options in the treatment of epilepsy in both pediatric and adult patients. Additionally, there is a small but growing interest in treating other neurological disorders with dietary interventions - such as calorie restriction - that share some biochemical similarities with the KD. These conditions include Parkinson's disease, Alzheimer's disease, amyotrophic lateral sclerosis, traumatic brain & spinal cord injury, and even brain tumors. That dietary factors should influence brain function is not altogether surprising, but it is important to note that such treatments can exert such profound clinical effects, where in many instances drugs have failed to produce lasting effects. A greater fundamental understanding of dietary and metabolic effects of brain function and disease processes is required to develop novel and effective strategies for what are often considered neurodegenerative and/or debilitating disorders. This symposium is aimed at neurologists, epileptologists, research scientists, nurses, dietitians, and other allied health professionals, with the fundamental goal of sharing up-to-date information on this rapidly expanding topic, and defining the important clinical and research questions that should be pursued in the future. Additionally, this symposium will provide a forum for extended discussions regarding practical clinical implementation, surveillance of adverse effects, and importantly, a critical look at basic cellular and molecular mechanisms that could account for the anticonvulsant and neuroprotective effects of the ketogenic diet. This symposium will be held over three full days, and will consist of both plenary sessions and mini- symposia, as well as poster and break-out sessions devoted to specific groups of healthcare professionals and researchers. While much of the focus of the symposium will be on dietary treatments for epilepsy, the final day will review our clinical and experimental experience with dietary therapies for other neurological disorders (including Alzheimer's and Parkinson's diseases, brain tumors and neurotrauma), paving the way toward a greater understanding of how dietary substrates, and the biochemical and metabolic consequences of their administration, can protect the diseased brain. An additional practical short-term goal will be to have attendees share information and establish clinical and research collaborations. It takes a multidisciplinary team to successfully implement the ketogenic diet, study it appropriately, and improve upon it. This spirit of cooperation constitutes the core rationale for this international symposium.
The fundamental goal of this symposium is to share up-to-date information on the rapidly expanding topic of dietary therapies for epilepsy, and to define the important clinical and research questions that should be pursued in the future. While there have been a few international meetings devoted to the topic of the KD, none have comprehensively examined both clinical and basic science aspects of this time-honored treatment. As such, we believe that this symposium may be the first landmark scientific meeting devoted to this long-neglected area of medicine. ? ? ? ?
| Rho, Jong M; Sankar, Raman (2008) The ketogenic diet in a pill: is this possible? Epilepsia 49 Suppl 8:127-33 |
| Wirrell, Elaine C (2008) Ketogenic ratio, calories, and fluids: do they matter? Epilepsia 49 Suppl 8:17-9 |
