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t m c » p u l s e | m a r c h 2 0 1 8 17 to improve mood, maybe because it decreases seizures. It may help sleep, and in some people, it may even help cognition a bit." For some types of epilepsy, the ketogenic diet is so effective that it becomes the primary treatment. Disorders of brain metabolism, including a genetic abnormality called GLUT1 deficiency syndrome and a neurodegenerative disorder called pyruvate dehydrogenase complex deficiency, respond especially well to the diet, Schultz explained. "For those children, particularly the children with GLUT1 disorder, they can become seizure-free almost immediately once they're placed on a ketogenic diet," said Schultz, who recalled that one patient who was suffering from hundreds of seizures a day no longer experienced them after fewer than three days of the high-fat, low-carb regimen. "The dramatic changes that you can see in those patients are quite remarkable," Clarke added. "They may be severely impaired, unable to engage with parents or the outside world. But with that change in diet, many of these kids can interact appropriately and significantly alter their lives." Individuals with these types of epilepsies are encouraged to adhere to the restrictive diet throughout their lifetime; after all, they suf- fer from a genetic disorder that you can't outgrow. But that's not necessarily the case for children with epilepsy caused by other bio- logical errors, in which the standard of care is to follow the ketogenic diet for just two years. "One reason we say that is, even though the diet has been around for 90 years or more, we still don't have any longitudinal data to tell us what the cardiovascular risks are," Schultz said. "The thought is that two years is a safe period of time to be on it, but beyond that we can't answer some of the long-term risks. Having said that, I have patients who have been on the diet for far more than two years because it's the most effective treatment for their seizures." Interestingly, for many patients, just two years on the diet can have lasting effects. Clarke described it as a "reset button" and explained that the diet sometimes helps stabilize the brain in a way that persists long after the reintroduction of glucose. But patients like Kristin are the exception. No falling, no thrashing Kristin was just 4 years old the first time her mother, Sarah Ybarra, noticed she was having a seizure. More than likely, Sarah said, it wasn't the first, but Kristin's seizures were not apparent. There was no falling to the floor, no thrashing— nothing like you see in the movies. (continued) Rebecca J. Schultz, Ph.D., RN, pediatric nurse practitioner at Texas Children's Hospital Epilepsy Center, left, with the Ybarra family during a routine appointment. License to... Adaptive Driving Access has one of the largest selections of lifts and mobility equipment in Texas. ADA offers only the highest quality products available in our industry. We have what you need to help get you on your way, because your mobility is our mission. • Wheelchair Accessible Vehicles • New & Certified Pre-owned Inventory • Adaptive Mobility Products • Scooter Lifts • 24/7 Emergency Assistance • Maintenance & Repair Service Call for details! PASADENA | HOUSTON | CORPUS CHRISTI | MCALLEN | COLLEGE STATION ADAPTIVEDRIVING.COM