Ketogenic Diet Therapy for Epilepsy

low-carb foods for a ketogenic diet

One of the oldest treatments for epilepsy is the classic ketogenic diet, which involves consuming high-fat foods and very few carbohydrates. Johns Hopkins is a longstanding pioneer in this mode of therapy.

In order to be successful, this therapy calls for strict compliance and plenty of patience, especially in the beginning. Most important, patients with epilepsy should only use the diet with the support of a knowledgeable ketogenic diet team, including a doctor and a licensed dietitian who can correctly calculate and monitor the diet for each individual.

Ketogenic Diet for Epilepsy: Why Choose Johns Hopkins

As a patient, you benefit from the support of our highly skilled dietitians and neurologists who work together and customize the diets to fit your health goals and lifestyle.

  • The pediatric epilepsy team at Johns Hopkins has almost 100 years of experience in treating epilepsy with the ketogenic diet.
  • More than 1,500 children have been enrolled in our ketogenic diet program for seizures.
  • Johns Hopkins developed the modified Atkins diet in 2002 as a treatment for adolescents and adults and opened the world’s first adult epilepsy diet center.

For Children: The Pediatric Ketogenic Diet Center

The pediatric epilepsy team at Johns Hopkins has used the high fat, low carbohydrate ketogenic diet to address seizures since the diet’s therapeutic origins in the 1920s. We are one of the premiere centers in the world for clinical and research expertise on the ketogenic diet, having treated over 1,500 children with this approach. 

Our group collaborates with many other epilepsy centers around the world, including our partners at Johns Hopkins All Children’s Hospital in Florida.

Treatment for Your Child

After parents submit the child’s medical information, our team reviews it carefully to determine if a ketogenic diet is an appropriate treatment, and which version may work best for each child. We usually see the child for a one-hour office visit before admission to the ketogenic diet program.

We admit approximately four children ranging from infants to adolescents each month to participate in the therapeutic ketogenic diet program. New patients take part in a 3-day orientation (Monday through Wednesday) that starts the child on the diet and provides education for the family. After that, we follow up with the patients in our clinic every one to three months.

Ketogenic Diet: Second Opinions

In many ways, the ketogenic diet is as much an art as a science, and effective fine-tuning of any child’s diet depends on experience.

With this in mind, our experts offer single, hour-long, second opinion visits and dietary guidance for families of children who are working with other ketogenic diet centers. Parents can contact the center 410-955-4259 for details on how to send medical records for review.

Training International Professionals

Practitioners from hospitals both in the U.S. and abroad who wish to start a ketogenic diet center at their institutions can participate in one of our 1- or 2-week training sessions for a fee. The training covers both the ketogenic and modified Atkins diets. Professionals affiliated with centers already using ketogenic diet programs are welcome to attend our monthly ketogenic diet follow-up clinics.

Our Team

Pediatric Ketogenic Diet Center Directors

Registered Dietitians: Zahava Turner, R.D. (Pediatrics), Courtney Haney, R.D. (Pediatrics), Jamie Houdek, R.D. (Pediatrics), Stacey Bessone, R.D. (Pediatrics – All Children’s Hospital)

Administrative Coordinator (schedules appointments): Tarah Majestic

For Adults: Johns Hopkins Adult Epilepsy Diet Center

The ketogenic diet has been used to treat children with epilepsy for almost a century. Our center, which opened in 2010, is the first-ever clinic to offer ketogenic diet therapy specially designed for adults with epilepsy.

Our regimen is a modification of the classic ketogenic diet, similar to the Atkins diet. Recent studies have shown that this modified Atkins diet lowers seizure rates in nearly half of adults that try it, usually within a few months. Unlike the ketogenic diet for children, this therapy does not require a hospital stay, an initial fasting period, food weighing, fluid measuring, or calorie counting.

Your local neurologist will continue to be your primary neurologist and prescribe your seizure medications and the clinic provides consultative services.

Candidacy: Ketogenic Diet as a Treatment for Epilepsy

Our clinic is recommended to adults with epilepsy who fit one or more of these criteria:

  • You have tried multiple medications for seizure control in the past with limited success.
  • You have a vagus nerve stimulator.
  • You have glucose type 1 transporter deficiency syndrome (GLUT1 DS)
  • You have gotten good results with ketogenic diet therapies for epilepsy in the past and want to try again.
  • You are an adult with epilepsy who is overweight, or who has diabetes, obstructive sleep apnea or high blood pressure.
  • You are awaiting epilepsy surgery.

Preparing for Your Appointment

If you are from outside the Baltimore/Washington area, your your local neurologist will continue to be your primary neurologist and handle your seizure medications. We will need all your medical records in advance so we can review them and ensure the modified Atkins diet or ketogenic diet is appropriate for you. International patients should request appointments through the Johns Hopkins International Office.

We will also request lab work in advance as well to check your kidney function and cholesterol. If the diet is appropriate, we will then check your insurance and schedule you for a one-hour clinic visit with one of our epileptologists, either Dr. Cervenka or Dr. McDonald.

We will ask you to keep a three-day record of all of the foods you eat before coming to see us in clinic. 

What to Expect

First Visit: Starting the Modified Atkins Diet
Your first visit is likely to be scheduled on a Friday and last from the morning into the afternoon. You will see the epilepsy doctor and the dietitian.

After the visit you can join other new dietary therapy patients at a teaching session presented by the Adult Epilepsy Diet Center team that introduces you to the diet. You will receive helpful references and recipes to get you started, and also have an opportunity to meet with the dietitian one-on-one for individualized counseling.

Starting the Diet
Once you start on the diet, it is important to not change your seizure medications immediately so that we can gauge the effects of the diet on your seizures. We will ask you to check and keep track of your urine ketones and your weight, and to keep a seizure calendar.

Following Up
After starting the diet, you can schedule 30-minute follow-up visits with our Center. We offer clinic visits approximately twice a month at our Baltimore location.

Our Team

Adult Epilepsy Diet Center Directors

Mackenzie C. Cervenka, M.D.
Tanya McDonald, M.D., Ph.D.

Epilepsy Fellow: Susan Fong, M.D., Ph.D.
Dr. Fong studies the impact of ketogenic diets on bone health in adults with epilepsy.

Registered Dietitians: Bobbie Henry-Barron, R.D. and Dianne Vizthum, R.D.

Nurse Coordinator (coordinates management on the diet): Rebecca Fisher, R.N.

Administrative Coordinator (schedules appointments): Joanne Barnett: 443-287-0423, ext. 3