Of all of the books I have read on epilepsy, few are "unique." This book fits that category well. It is fun to see what people that "think outside of the box " are writing.
The book is organized into three sections. Part I includes an introductory scientific chapter about seizures. It provides the reader with the theoretical background needed to understand the material in Part III (Basic Science) and several of the earlier chapters. Part II is mostly a "how to do it" (the ketogenic diet) for health care professionals. It also includes chapters on indications and complications. Section II concludes with a particularly intriguing chapter on other dietary treatments (besides the ketogenic diet) for epilepsy.
For this reader the high point of the book started with the first chapter in Part III and continued right to the end of the book. Biochemical effects of the ketogenic diet are examined, citing scientific studies. Possible explanations for the anti-seizure/anti-epileptic effect of the ketogenic diet are set forth; cerebral energy metabolism, effects on amino acids, molecular regulation, neuronal excitability, effects of caloric restriction, the role of norepinephrine, galanin and neuropeptide Y, etc. Some surprising results are noted. For example, in the chapter on caloric restriction it is suggested that high glucose levels may exacerbate human epilepsies. On a superficial level this is just the opposite of what medical students are taught; i.e., hypoglycemia (not hyperglycemia) causes seizures, which it can.
The "Afterword", is by Jim Abrahams, father of Charlie Abrahams of Charlie Foundation fame. The piece he wrote or something like it should be given to every parent of a child newly diagnosed with epilepsy. Not that all the kids should go on the ketogenic diet, but rather that the parents should know that treating epilepsy is a complicated and even "artsy" endeavor. They should also know that there are many factors that may possibly affect their child's seizures and that there are many treatment options available. Another fact that he alludes to is that early control is important and that if that fact were known, parental complacency early on would be rare.
In all fairness to physicians, most parents whether they realize it or not are quite distraught when their children first develop seizures. Instantaneous assimilation of massive amounts of information is difficult if not impossible under those circumstances even for the medically sophisticated parent. Physicians may be reluctant to throw everything at parents all at once. However, the high degree of parental focus precipitated by the crisis of a child developing a chronic disease, can be the driving force for a parent to devote great energies toward learning about their child's illness. The act of learning can to a great degree allay the extreme anxiety the parents may feel. Physicians can help by suggesting non-technical publications for the parents to read as a starting point in their quest for knowledge. They can also acknowledge the potential benefits of other treatments that the parents may have discovered on the Internet for example. It would be nice if physicians know what does not work as well, and have enough knowledge and credibility with the parents to be able to explain why.
This is a great book for clinicians that want to understand the possible scientific basis for the efficacy of the ketogenic diet. It will greatly broaden one's view of the disease as well.
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