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Diet Treatment Call for Epilepsy

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A special high-fat diet helps to control fits in children with epilepsy, a UK trial suggests.

The number of seizures fell by a third in children on the “ketogenic” diet, where previously they had suffered fits every day despite medication.

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Seizures are caused by bursts of electrical activity in the brain

The diet alters the body’s metabolism by mimicking the effects of starvation, the researchers reported in the Lancet Neurology.

The researchers called for the diet to be more widely available on the NHS.

It is the first trial comparing the diet with routine care, even though it has been around since the 1920s.

Children are given a tailored diet very high in fat, low in carbohydrate and with controlled amounts of protein.

It is not exactly clear how it works but it seems that ketones, produced from the breakdown of fat, help to alleviate seizures.

A total of 145 children aged between two and 16 who had failed to respond to treatment with at least two anti-epileptic drugs took part in the study.
“The parents say the first two weeks are quite difficult but then it becomes much easier because you can make foods in bulk and it especially helps if you can see the benefits from it”:…………says Professor Helen Cross

Half started the diet immediately and half waited for three months.

The number of seizures in the children on the diet fell to two-thirds of what they had been, but remained unchanged in those who had not yet started the diet, the researchers reported.

Five children in the diet group saw a seizure reduction of more than 90%.

However, there were some side-effects including constipation, vomiting, lack of energy and hunger.

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Professor Helen Cross, study leader and consultant in neurology at Great Ormond Street Hospital in London, said the diet had been around for a long time but had fallen out of favour because it was thought to be too difficult to stick to.

“The parents say the first two weeks are quite difficult, but then it becomes much easier because you can make foods in bulk and it especially helps if you can see the benefits from it,” she said.

“We have to be sensible about it, in this study we had children who had complex epilepsy.

“If your epilepsy is easily controlled on one medication then I wouldn’t advocate the diet, but if at least two drugs have failed then it should be considered.”

She said national guidelines recommend the diet as a treatment option, but a shortage of dieticians meant it was often unavailable.

A spokesperson for Epilepsy Action said: “The results of this trial add valuable information to what is already known about the diet, presenting evidence that it works for some children with drug-resistant epilepsy.

“In addition to this, however, we also recognise that the ketogenic diet is not without its side-effects, and that the risks and benefits should be considered before prescribing, as with drug treatment.”

She said the results would hopefully encourage wider inclusion of the diet in the management of children with drug-resistant epilepsy.

Click to see also:->

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Epilepsy took away my childhood

Epilepsy genes ‘may cut seizures

Within days she seemed calmer

Sources: BBC NEWS:3rd. May’08

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Leukaemia Cell Culprit Discovered

A study of four-year-old twin girls has identified a rogue cell that is the root cause of childhood leukaemia.The finding could mean more specific and less intensive treatments for all children with the blood cancer.

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..Isabella (l) and Olivia both have the pre-leukaemic stem cells

Both twins were found to have the “pre-leukaemic” cells in their bone marrow, although to date only one has developed leukaemia.

UK researchers reported in Science that a second genetic mutation is needed for full-blown disease to develop.

Leukaemia occurs when large numbers of white blood cells take over the bone marrow leaving the body unable to produce enough normal blood cells.

Along with lymphoma it accounts for almost half of childhood cancers.

Olivia Murphy, from Bromley in Kent, developed acute lymphoblastic leukaemia when she was two-years old – but so far her twin sister, Isabella, is healthy.

Researchers found they both have “pre-leukaemic stem cells” containing a mutated gene, which forms when the DNA is broken and rejoined at another point.

The pre-leukaemic cells are transferred from one twin to the other in the womb through their shared blood supply.

But it takes another genetic mutation in early childhood for the cells to cause disease.

This second mutation, which may be caused by infection, occurred in Olivia but not Isabella.

Doctors do regular tests on Isabella to look for signs of the cancer but once she reaches adolescence it is thought the rogue cells will disappear.
Achilles heel

About 1% of the population is thought to be born with pre-leukaemia cells. Of these, 1% receive the second “hit” that leads to cancer.

Current treatments are far too aggressive to justify eliminating the rogue cells before cancer develops, which also means screening is unlikely.

But attacking the pre-leukaemic cells in children with leukaemia would be a better way of treating the disease and ensuring it does not come back, the researchers said.

Study leader Professor Tariq Enver, from the Medical Research Council Molecular Haematology Unit in Oxford, said: “These are the cells which drive and maintain the disease.

“Now we know about the cell, hopefully we can find an Achilles heel we can target.”

Professor Mel Greaves, from the Institute of Cancer Research and co-author on the study, said he suspected that the stem cells could escape conventional chemotherapy and cause relapse.

He said the study in the twins had been unique.

“There is an element of chance, we still have to work out why it happens in one child and not the other.

“We’re pretty certain it’s triggered by common childhood infection.”

Dr Phil Ancliff, consultant in paediatric haematology at Great Ormond Street Hospital, said 90% of children now survived leukaemia because of intensive chemotherapy, but that it came at a price.

Now we know about the cell, hopefully we can find an Achilles heel we can target” said Professor Tariq Enver
‘We were lucky’

Olivia lost the sight in one eye after she was unable to fight an infection due to her cancer treatment.

“A significant number of children are now being over-treated but we don’t know which children,” he said.

In the future, he added, children could be tested to see if the stem cells had been killed off after the first few weeks of chemotherapy with some being able to stop treatment earlier, sparing them harmful side-effects.

Dr Bruce Morland, consultant paediatric oncologist at Birmingham Children’s Hospital and chairman of the Children’s Cancer and Leukaemia Group, said: “The identification of the leukaemic stem cell has been one of the ‘Holy Grails’ for cancer biologists and this study certainly brings us one step closer.”

Professor Vaskar Saha, professor of paediatric oncology at Cancer Research UK, said: “This important paper shows how leukaemia develops, and how it can persist even after therapy.

“By identifying the cells involved, it raises the hope that we will be able to identify children at risk of relapse, and develop new, targeted drugs to treat the disease.”

Click to read :Childhood Leukaemia

“We know we have been lucky’

‘Stem cell find for child cancer

Children’s drug treatment boost

Sticky DNA helps spot leukaemia

Richer areas ‘child cancer risk’

Child cancer ‘three gene screen’

Sources: BBC NEWS 17TH. JAN’08