ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Thursday, February 20, 1997 TAG: 9702200013
SECTION: EXTRA PAGE: 6 EDITION: METRO
SOURCE: SALLY SQUIRES THE WASHINGTON POST
A 70-year-old diet treatment for epilepsy is in the spotlight after being featured last weekend in a made-for-television movie starring Meryl Streep. ``First Do No Harm,'' which aired on ABC television Sunday, depicts a young boy's struggle with uncontrolled epilepsy and the emotional and financial toll that the disorder takes on his family.
In the film, his mother learns of the ketogenic diet in a medical textbook and, in Hollywood fashion, battles unsympathetic doctors to get her son on this regimen. She succeeds after great effort.
Her son becomes seizure-free overnight and no longer requires heavy doses of anticonvulsant drugs that make him lethargic and bedridden. The last shot of the movie shows him healthy and riding a white horse down Main Street in a Fourth of July parade.
Despite this Hollywood presentation, ``none of us think that this diet is a cure for epilepsy,'' said Wendy G. Mitchell, professor of neurology and pediatrics at Children's Hospital in Los Angeles.
The reality is that the ketogenic diet is a demanding regimen that has been used for decades with some success. Even its staunchest supporters say it has limited potential.
``Children who have just had a few seizures are likely to be controlled with one of a number of medicines that are much easier to take than the diet,'' said neurologist John Freeman, director of the pediatric epilepsy center at the Johns Hopkins Medical Institutions in Baltimore, who has helped train other doctors to use the diet.
Developed in the late 1920s after a New York pediatrician observed that three patients who fasted with a faith healer temporarily stopped having seizures, the ketogenic diet tricks the body into believing it is starving. By switching to a diet with 70 to 90 percent of calories from fat and only very limited amounts of carbohydrates, the body becomes deprived of glucose and begins breaking down fat cells for energy.
Ketone bodies - breakdown products of the contents of fat cells - serve as food for starving cells throughout the body. Children stay on the diet for about two years and then are evaluated. If their seizures remain under control during the evaluation, they may be allowed to resume a regular diet. Otherwise they go back on the ketogenic program.
Why this diet helps reduce seizures in about a third of children with the most severe form of epilepsy is not understood. But Freeman and others believe that if they could pinpoint the action of ketone bodies, they would have a better understanding of epilepsy. ``And then maybe we could develop a pill that could one day replace the ketogenic diet,'' he said.
At Johns Hopkins, Freeman worked with registered dietitian Millicent Kelly to treat about eight to 10 children a year with intractable epilepsy. But that number grew dramatically in 1994 after filmmaker Jim Abrahams and his wife, Nancy, flew their son Charlie to Hopkins for treatment.
Charlie responded so well to the diet that he was able to stop all medications. The Abrahamses told their story to the NBC television show ``Dateline,'' formed the Charlie Foundation to reignite interest in the ketogenic diet treatment and sponsored a conference at Hopkins to train other doctors in the diet. About a dozen medical centers now offer the diet treatment, which can take families months to learn.
Neurologists throughout the country are bracing this week for another wave of interest in the diet, kindled by the airing of ``First Do No Harm,'' which was directed and produced by Jim Abrahams. But they underscore that the diet is not as simple or always as effective as its television portrayal suggests.
Parents must be highly motivated to even consider the diet treatment for their children. ``You have to be a pharmacist, a mathematician, a chemist and a 24-hour food cop to do this diet,'' said Tracey Flourie, whose 10-year-old son, Skyler, has been on the program for four years. ``You have to be innovative, flexible and have an enormous working knowledge of it.''
LENGTH: Medium: 72 linesby CNB