Dr Eileen Mc Manus is an Advanced Trainee in Neurology working at Waikato General Hospital, Hamilton, New Zealand. She was born and trained in Ireland, gaining both MBChB and Neuroscience MSc from Trinity College Dublin 2013. She moved to New Zealand in 2015, working first in Thames Hospital and then Waikato General Hospital. In her spare time, she is an avid hiker and loves the outdoors including landscape photography.
Ketogenic Diet in Drug-Resistant Epilepsy with Encephalopathy and Post Ictal Pyschosis
Up to 40% of patients with epilepsy are diagnosed with drug-resistant epilepsy (DRE). Cognitive decline and loss of independence are devastating consequences of uncontrolled epilepsy. Ketogenic diets (KD) mimic the metabolic profile of fasting, altering neuron energetics and stabilizing neuron synaptic function. They have an established role in the treatment of DRE. We present the case of a 30-year-old male with an 18-year history of DRE, post ictal psychosis and significant cognitive impairment. All attempts at seizure control failed until he was finally put on a ketogenic diet, which greatly reduced the seizure frequency. His anxiety has improved and his post ictal psychosis has fully resolved. This resolution of psychosis has been maintained solely with KD for the last 10 months. We wish to highlight that a ketogenic diet is a viable alternative to anti-epileptic medications and surgery. We propose that it should be considered early on if anti-epileptic medications are proving ineffective