Seminars in Pediatric Neurology
Volume 12, Issue 2 , Pages 106-113 , June 2005

Nonpharmacological Treatment Options for Epilepsy

  • Raj D. Sheth, MD

      Affiliations

    • Corresponding Author InformationAddress reprint requests to Raj D. Sheth, MD, Professor, Department of Neurology, 600 Highland Avenue, H6/574 CSC, Madison, WI 53792-5132.
    • ,
  • Carl E. Stafstrom, MD, PhD
    • ,
  • David Hsu, MD, PhD

References 

  1. Camfield C , Camfield P , Gordon K , et al.   Outcome of childhood epilepsy (a population-based study with a simple predictive scoring system for those treated with medication) . J Pediatr . 1993;122:861–868
  2. Pellock JM . Managing pediatric epilepsy syndromes with new antiepileptic drugs . Pediatrics . 1999;104:1106–1116
  3. Camfield PR , Camfield CS , Gordon K , et al.   If a first antiepileptic drug fails to control a child’s epilepsy, what are the chances of success with the next drug? . J Pediatr . 1997;131:821–824
  4. Camfield PR , Camfield CS . Antiepileptic drug therapy (when is epilepsy truly intractable?) . . Epilepsia . 1996;37(suppl 1):S60–S65
  5. Shields WD , Shewmon DA , Chugani HT , et al.   Treatment of infantile spasms (medical or surgical?) . Epilepsia . 1992;33(suppl 4):S26–S31
  6. Chugani HT , Shewmon DA , Shields WD , et al.   Surgery for intractable infantile spasms (neuroimaging perspectives) . Epilepsia . 1993;34:764–771
  7. Dunn DW , Austin JK , Huster GA . Symptoms of depression in adolescents with epilepsy . J Am Acad Child Adolesc Psychiatr . 1999;38:1132–1138
  8. Sheth RD , Stafstrom CE . Intractable pediatric epilepsy (vagal nerve stimulation and the ketogenic diet) . Neurol Clin . 2002;20:1183–1194
  9. Ben-Menachem E . Vagus nerve stimulation for the treatment of epilepsy . Lancet Neurol . 2002;1:477–482
  10. Theodore WH , Fisher RS . Brain stimulation for epilepsy . Lancet Neurol . 2004;3:111–118
  11. Zabara J . Inhibition of experimental seizures in canines by repetitive vagal stimulation . Epilepsia . 1992;33:1005–1012
  12. Penry JK , Dean JC . Prevention of intractable partial seizures by intermittent vagal stimulation in humans (preliminary results) . Epilepsia . 1990;31(suppl 2):S40–S43
  13. Uthman BM , Wilder BJ , Penry JK , et al.   Treatment of epilepsy by stimulation of the vagus nerve . Neurology . 1993;43:1338–1345
  14. Crumrine PK . Vagal nerve stimulation in children . Semin Pediatr Neurol . 2000;7:216–223
  15. McLachlan RS . Suppression of interictal spikes and seizures by stimulation of the vagus nerve . Epilepsia . 1993;34:918–923
  16. Henry TR , Bakay RA , Pennell PB , et al.   Brain blood-flow alterations induced by therapeutic vagus nerve stimulation in partial epilepsy: II. Prolonged effects at high and low levels of stimulation . Epilepsia . 2004;45:1064–1070
  17. Wheless JW , Baumgartner J , Ghanbari C . Vagus nerve stimulation and the ketogenic diet . Neurol Clin . 2001;19:371–407
  18. Helmers SL , Wheless JW , Frost M , et al.   Vagus nerve stimulation therapy in pediatric patients with intractable epilepsy (retrospective study) . J Child Neurol . 2001;16:843–848
  19. Amar AP , Heck CN , Levy ML , et al.   An institutional experience with cervical vagus nerve trunk stimulation for medically refractory epilepsy (rationale, technique, and outcome) . Neurosurgery . 1998;43:1265–1276
  20. Amar AP , DeGiorgio CM , Tarver WB , et al.   Long-term multicenter experience with vagus nerve stimulation for intractable partial seizures (results of the XE5 trial) . Stereotact Funct Neurosurg . 1999;73:104–108
  21. Amar AP , Heck CN , DeGiorgio CM , et al.   Experience with vagus nerve stimulation for intractable epilepsy (some questions and answers) . Neurol Med Chir (Tokyo) . 1999;39:489–495
  22. Ben-Menachem E , Manon-Espaillat R , Ristanovic R , et al.  First International Vagus Nerve Stimulation Study Group   Vagus nerve stimulation for treatment of partial seizures: 1. A controlled study of the effect on seizures . Epilepsia . 1994;35:616–626
  23. DeGiorgio CM , Schachter SC , Handforth A , et al.   Prospective long-term study of vagus nerve stimulation for the treatment of refractory seizures . Epilepsia . 2000;41:1195–1200
  24. Morris GL , Mueller WM  The Vagus Nerve Stimulation Study Group E01-E05 . Long-term treatment with vagus nerve stimulation in patients with refractory epilepsy . Neurology . 1999;53:1731–1735
  25. Murphy JV , Wheless JW , Schmoll CM . Left vagal nerve stimulation in six patients with hypothalamic hamartomas . Pediatr Neurol . 2000;23:167–168
  26. Wilder RM . The effects of ketonemia on the course of epilepsy . Mayo Clinic Proc . 1921;2:307–308
  27. Swink TD , Vining EPG , Freeman JM . The ketogenic diet (1997) . Adv Pediatr . 1997;44:297–329
  28. Wheless JW . History and origin of the ketogenic diet . In:  Stafstrom CE ,  Rho JM editor. Epilepsy and the Ketogenic Diet . Totowa, NJ: Humana Press; 2004;p. 31–50
  29. Schwartzkroin P . Mechanisms underlying the anti-epileptic efficacy of the ketogenic diet . Epilepsy Res . 1999;37:171–180
  30. Stafstrom CE , Bough KJ . The ketogenic diet for the treatment of epilepsy (a challenge for nutritional neuroscientists) . Nutr Neurosci . 2003;6:67–79
  31. Likhodii SS , Burnham WM . The effects of ketone bodies on neuronal excitability . In:  Stafstrom CE ,  Rho JM editor. Epilepsy and the Ketogenic Diet . Totowa, NJ: Humana Press; 2004;p. 217–228
  32. Stafstrom CE , Rho JM . Epilepsy and the Ketogenic Diet . Totowa, NJ: Humana Press; 2004;
  33. Freeman JM , Freeman JB , Kelly MT . The Ketogenic Diet—A Treatment for Epilepsy . New York, NY: Demos Publications; 2000;
  34. Zupec-Kania B , Werner RR , Zupanc ML . Clinical use of the ketogenic diet (the dietician’s role) . In:  Stafstrom CE ,  Rho JM editor. Epilepsy and the Ketogenic Diet . Totowa, NJ: Humana Press; 2004;p. 63–81
  35. Ballaban-Gil K , Callahan C , O’Dell C , et al.   Complications of the ketogenic diet . Epilepsia . 1998;39:744–748
  36. Wheless JW . The ketogenic diet (an effective medical therapy with side effects) . J Child Neurol . 2001;16:633–635
  37. Peterman MG . The ketogenic diet in epilepsy . JAMA . 1925;84:1979–1983
  38. Helmholz HF , Keith HM . Eight years’ experience with the ketogenic diet in the treatment of epilepsy . JAMA . 1930;95:707–709
  39. Livingston S . Dietary treatment of epilepsy . In:  Livingston S editors. Comprehensive Management of Epilepsy in Infancy, Childhood and Adolescence . Springfield, IL: Charles C. Thomas; 1972;p. 378–405
  40. Vining E , Freeman J , Ballaban-Gil K , et al.   A multicenter study of the efficacy of the ketogenic diet . Arch Neurol . 1998;55:1433–1437
  41. LeFevre F , Aronson N . Ketogenic diet for the treatment of refractory epilepsy in children (a systematic review of efficacy) . Pediatrics . 2000;105:E46
  42. Magrath G , MacDonald A , Whitehouse W . Dietary practices and use of the ketogenic diet in the UK . Seizure . 2000;9:128–130
  43. Coppola G , Veggiotti P , Cusmai R , et al.   The ketogenic diet in children, adolescents and young adults with refractory epilepsy (an Italian multicentric experience) . Epilepsy Res . 2002;48:221–227
  44. Levy R , Cooper P . Ketogenic diet for epilepsy . Cochrane Database Syst Rev . 2003;3:
  45. Maydell BV , Wyllie E , Akhtar N , et al.   Efficacy of the ketogenic diet in focal versus generalized seizures . Pediatr Neurol . 2001;25:208–212
  46. Kossoff EH , Pyzik PL , McGrogan JR , et al.   Efficacy of the ketogenic diet for infantile spasms . Pediatrics . 2002;109:780–783
  47. Nordli DR , Kuroda MM , Carroll J , et al.   Experience with the ketogenic diet in infants . Pediatrics . 2001;108:129–133
  48. Sirven J , Whedon B , Caplan D , et al.   The ketogenic diet for intractable epilepsy in adults (preliminary results) . Epilepsia . 1999;40:1721–1726
  49. Sperling MR , Nei M . The kerogenic diet in adults . In:  Stafstrom CE ,  Rho JM editor. Epilepsy and the Ketogenic Diet . Totowa, NJ: Humana Press; 2004;p. 103–109
  50. Hemingway C , Freeman JM , Pillas DJ , et al.   The ketogenic diet (a 3- to 6-year follow-up of 150 children enrolled prospectively) . Pediatrics . 2001;108:898–905
  51. Freeman J , Vining E , Pillas D , et al.   The efficacy of the ketogenic diet—1998 (a prospective evaluation of intervention in 150 children) . Pediatrics . 1998;102:1358–1363
  52. Pulsifer M , Gordon J , Vining E , et al.   Effects of the ketogenic diet on development and behavior (preliminary report of a prospective study) . Dev Med Child Neurol . 2001;43:301–306
  53. Freeman JM . The ketogenic diet and epilepsy . Nestle Nutrition Workshop Series Clinical and Performance Program . 2001;5:307–321
  54. Sokoloff L . Metabolism of ketone bodies by the brain . Ann Rev Med . 1973;24:271–279
  55. Nordli DR , DeVivo DC . Effects of the ketogenic diet on cerebral energy metabolism . In:  Stafstrom CE ,  Rho JM editor. Epilepsy and the Ketogenic Diet . Totowa, NJ: Humana Press; 2004;p. 179–184
  56. Thio L , Wong M , Yamada K . Ketone bodies do not directly alter excitatory or inhibitory hippocampal transmission . Neurology . 2000;54:325–331
  57. Likhodii SS , Serbanescu I , Cortez MA , et al.   Anticonvulsant properties of acetone, a brain ketone elevated by the ketogenic diet . Ann Neurol . 2003;54:219–226
  58. Yudkoff M , Daikhin Y , Nissim I . The ketogenic diet (interactions with brain amino acid handling) . In:  Stafstrom CE ,  Rho JM editor. Epilepsy and the Ketogenic Diet . Totowa, NJ: Humana Press; 2004;p. 185–199
  59. Sullivan PG , Rippy NA , Dorenbos K , et al.   The ketogenic diet increases mitochondrial uncoupling protein levels and activity . Ann Neurol . 2004;55:576–580
  60. Greene AE , Todorova MT , Seyfried TN . Perspectives on the metabolic management of epilepsy through dietary reduction of glucose and elevation of ketone bodies . J Neurochem . 2003;86:529–537
  61. Withrow CD . The ketogenic diet (mechanisms of anticonvulsant action) . In:  Glaser GH ,  Penry JK ,  Woodbury WM editor. Antiepileptic Drugs (Mechanisms of Action) . New York, NY: Raven Press; 1980;p. 635–642
  62. Bough KJ , Eagles DA . A ketogenic diet increases the resistance to pentylenetetrazole-induced seizures in the rat . Epilepsia . 1999;40:138–143
  63. Wirrel EC , Darwish HZ , Williams-Dyjur C , et al.   Is a fast necessary when initiating the ketogenic diet? . J Child Neurol . 2002;17:179–182
  64. DeVivo DC , Trifiletti RR , Jacobson RI , et al.   Defective glucose transport across the blood-brain barrier as a cause of persistent hypoglycorrhachia, seizures, and developmental delay . N Engl J Med . 1991;325:703–709
  65. Vining EPG , Pyzik P , McGrogan J , et al.   Growth of children on the ketogenic diet . Dev Med Child Neurol . 2002;44:796–802
  66. Huttenlocher PR , Wilbourn AJ , Signore JM . Medium-chain triglycerides as a therapy for intractable childhood epilepsy . Neurology . 1971;21:1097–1103
  67. Vaisleib  , Buchhalter JR , Zupanc ML . Ketogenic diet (outpatient initiation, without fluid, or caloric restrictions) . Pediatr Neurol . 2004;31:198–202
  68. Furth SL , Casey JC , Pyzik PL , et al.   Risk factors for urolithiasis in children on the ketogenic diet . Pediatr Nephrol . 2000;15:125–128
  69. Kwiterovich PO , Vining EPG , Pyzik P , et al.   Effect of a high-fat ketogenic diet on plasma levels of lipids, lipoproteins, and apolipoproteins in children . JAMA . 2003;290:912–920
  70. Sutherling JEN , Mele-Hayes D . How to maintain and support a ketogenic diet program (a nursing perspective) . In:  Stafstrom CE ,  Rho JM editor. Epilepsy and the Ketogenic Diet . Totowa, NJ: Humana Press; 2004;p. 83–94
  71. Stafstrom CE , Holmes GL . Dietary treatments for epilepsy other than the ketogenic diet . In:  Stafstrom CE ,  Rho JM editor. Epilepsy and the Ketogenic Diet . Totowa, NJ: Humana Press; 2004;p. 161–175
  72. Kossoff EH . More fat and fewer seizures (dietary therapies for epilepsy) . Lancet Neurol . 2004;3:415–420
  73. Atkins RC . Dr. Atkins’ New Diet Revolution . New York, NY: Avon; 2002;
  74. Kossoff EH , Krauss GL , McGrogan JR , et al.   Efficacy of the Atkins diet as a therapy for intractable epilepsy . Neurology . 2003;61:1789–1791
  75. Baxter P . Epidemiology of pyridoxine dependent and pyridoxine responsive seizures in the U.K . Arch Dis Child . 1999;81:431–433
  76. Baxter P . Pyridoxine-dependent seizures (a clinical and biochemical conundrum) . Biochim Biophys Acta . 2003;1647:36–41
  77. Gospe SM . Pyridoxine-dependent seizures (findings from recent studies pose new questions) . Pediatr Neurol . 2002;26:181–185
  78. Baxter P , Griffiths P , Kelly T , et al.   Pyridoxine-dependent seizures (demographic, clinical, MRI and psychometric features, and effect of dose on intelligence quotient) . Dev Med Child Neurol . 1996;38:998–1006
  79. Sterman MB . Studies of EEG biofeedback training in man and cats, in Highlights of 17th Annual Conference (VA Cooperative Studies in Mental Health and Behavioral Sciences) . 1972;50–60
  80. Sterman MB . Basic concepts and clinical findings in the treatment of seizure disorders with EEG operant conditioning . Clin Electroencephalogr . 2000;31:45–55
  81. Sterman MB , Friar L . Suppression of seizures in epileptics following sensorimotor EEG feedback training . Electroencephalogr Clin Neurophysiol . 1972;33:89–95
  82. Andrews DJ , Schonfeld WH . Predictive factors for controlling seizures using a behavioural approach . Seizure . 1992;1:111–116
  83. Lubar JF , Shabsin HS , Natelson SE , et al.   EEG operant conditioning in intractable epilepsies . Arch Neurol . 1981;38:700–704
  84. Kaplan BJ . Biofeedback in epileptics (equivocal relationship of reinforced EEG frequency to seizure reduction) . Epilepsia . 1975;16:477–485
  85. Gastaut H . Comments on “Biofeedback in epileptics: equivocal relationship of reinforced EEG frequency to seizure reduction” . Epilepsia . 1975;16:487–488
  86. Rockstroh B , Elbert T , Birbaumer N , et al.   Cortical self-regulation in patients with epilepsies . Epilepsy Res . 1993;14:63–72
  87. Kotchoubey B , Strehl U , Holzapel S , et al.   Negative potential shifts and the prediction of the outcome of neurofeedback therapy in epilepsy . Clin Neurophysiol . 1999;110:683–686
  88. Kotchoubey B , Strehl U , Uhlmann C , et al.   Modification of slow cortical potentials in patients with refractory epilepsy (a controlled outcome study) . Epilepsia . 2001;42:406–416
  89. Nagai Y , Goldstein LH , Critchley HD , et al.   Influence of sympathetic autonomic arousal on cortical arousal (implications for a therapeutic behavioural intervention in epilepsy) . Epilepsy Res . 2004;58:185–193
  90. Nagai Y , Goldstein LH , Fenwick PB , et al.   Clinical efficacy of galvanic skin response biofeedback training in reducing seizures in adult epilepsy (a preliminary randomized controlled study) . Epilepsy Behav . 2004;5:216–223
  91. Ramaratnam S , Baker GA , Goldstein L . Psychological treatments for epilepsy . Cochrane Database Syst Rev . 2003;4: CD002029

PII: S1071-9091(05)00042-2

doi: 10.1016/j.spen.2005.03.005

Seminars in Pediatric Neurology
Volume 12, Issue 2 , Pages 106-113 , June 2005

Article Tools