worst sz after 17 sz free days

June 29, 2002

Hi

had the best 17 days ever - with not 1 seizure. This has not ever

happened before. I thought we were home and hosed. When she broke her

previous record of 8 sz free days I dared not breathe a word of my

excitement for fear of jinxing it.

However, this morning she had a complex partial that secondarily

generalised into the worst seizure I have witnessed her to have. She was

in very poor shape afterwards too.

A reduction in her calories of 50g from 1780/day to 1730/day, since last

Thursday, is the only change I have made for some time. (This reduction

was done because she is gaining weight, with no increase in height) She has

3 meals per day, is on a 3.6:1 ratio, and at each meal she has

13.6g protein, 57g fat and 2.2g CHO. Prior to the reduction by 50 calories

she had 13.6g protein, 58.7g fat, 2.7g CHO.

I would appreciate any suggestions as to the possible causes for such a bad

seizure after a record with no seizures, and what action I should take.

I have a few thoughts and would welcome feedback on these also:

* The reduction in calories has increased ketosis. (her optium BOHB was

4.8, usually < 4.4)

However, prior to the seizure she was really happy and showed no signs of

being too ketotic.

* Increased BOHB has heightened the effect of Lamictal - maybe needs

another med reduction. (on 100mg bd, down from 200mg bd pre-diet)

* Reduced calories is causing her to burn body fat, releasing meds stored

in fat to be released into bloodstream. (In the past she has had many

different drugs - I am not sure which ones are likely to be accumulated in

body fat).

* 2.2g carbs per meal may not be sufficient.

* Should I do nothing and see how she goes?

* Should I reduce the ratio to slightly reduce ketosis? At 3.5:1 she would

be on similar carbs as before the calorie reduction, just the fat slightly

reduced.

ie before the reduction in calories she had 13.6g protein, 58.7g fat,

2.7g CHO. with each meal. At 3.5:1 with reduced calories she would have

13.6g protein, 56.9g fat, and 2.6g CHO. At 3.55:1 with the reduced

calories she would have: 13.6g protein, 56.9g fat and 2.4g CHO

I would welcome any input!

Jill

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