During a seizure, a number of neuronal networks fire when they are not supposed to. This can happen because more of the brain cells are in excited state and are releasing lots of excitatory neurotransmitters, like glutamate. Or it could be that neighboring brain cells aren’t able to suppress the continuous excitability like they normally would through inhibitory pathways using inhibitory neurotransmitters like gamma-aminobutyric acid, or GABA.
The ketogenic diet reduces the amount of glutamate in the brain and enhances the synthesis of GABA, making it less likely for a seizure to occur. The diet can also reduce inflammation in the brain, and inflammation due to infections like meningitis, encephalitis, or autoimmune disorders can trigger seizures.
There have also been a couple of really interesting studies recently that examined how the ketogenic diet can alter the gut microbiome, the trillions of microorganisms inhabiting the digestive tract. These studies found the ketogenic diet can increase certain bacteria species that promote an increased proportion of GABA to glutamate in the brain.
And diet is better for this management because after persistent use of the drug, dose of a drug or combination of drugs necessary to stop seizures can sometimes cause significant sedation. There are instances where patients have been able to control their seizures, but their quality of life is really impacted by side effects.
Referenced to Mackenzie Cervenka