Diet taboos for patients with epilepsy

There are not as many taboos on the diet of epilepsy patients as there are on the Internet. There are only three core red lines that need to be kept in mind: first, never touch any alcoholic beverages (including food with hidden alcohol such as fruit wine, fermented glutinous rice, and liqueur chocolate); second, avoid drinking a large amount of water at one time (including filling a large amount of drinks, soups, and ice products in a short period of time); third, never touch foods that will trigger self-attacks after eating. All the remaining "universal fasting requirements" actually have no absolute standards and completely vary from person to person.

Don’t tell me, I’ve been in Shenzhen for almost 6 years, and 90% of the patients I’ve seen who had attacks caused by diet were caused by alcohol. Not long ago, there was a 28-year-old programmer who had been taking medication regularly for more than three years without having a seizure. He couldn't wipe his face at the company's annual meeting and drank half a glass of low-alcohol fruit wine. He had a violent fit at home in the middle of the night and his forehead was bleeding. His family members regretted it when they sent him to the emergency room. It’s not that half a glass of wine is very powerful, but alcohol will directly interact with anti-epileptic drugs, quickly reduce blood drug concentration, and directly stimulate abnormal discharge of brain neurons. For epilepsy patients, this is a red line recognized by doctors all over the world, and there is no room for discussion.

Speaking of this, some people must ask, the old people often say that "fat foods" cannot be eaten. Are mutton, seafood, roosters, and leeks really banned? In fact, this topic has always been controversial. According to traditional Chinese medicine theory, it is indeed believed that such pungent and warm food may induce internal wind disturbance and increase the risk of attack. Many experienced Chinese medicine practitioners will advise patients to avoid appropriate foods. ； However, modern evidence-based medicine has yet to find large-scale clinical evidence that can prove a direct causal relationship between these foods and epileptic seizures. Among the patients I have treated, only two reported that they had attacks every time they ate seafood. Later, after investigation, I found out that they were severely allergic to seafood. The inflammatory reaction caused by the allergy stimulated the discharge of neurons, and it was not a problem with the seafood itself. There is really no need to kill all the "favorites" at once. If the family members have been eating mutton for half their lives without feeling sick, they can eat it when they need to. Eating green vegetable and white porridge every day will easily lead to poor nutrition, and weakened immunity will make it easier to get sick.

I was particularly impressed by a 13-year-old patient whose mother was very strict. Coke, milk tea, spicy bars were all banned, and even chocolate was not allowed in the school recess meals. As a result, the child ran 1,500 meters at the last sports meeting and was so thirsty that he secretly bought two bottles of ice Coke and drank it all in one go. Then he had a seizure on the playground in the afternoon. Later, it was found that the cause was not the fault of Coca-Cola at all, but drinking too much water in a short period of time. The concentration of anti-epileptic drugs in the blood was instantly diluted, which increased the water load on the brain and induced abnormal discharges. In fact, it's okay to take a sip of Coke or eat half a piece of chocolate occasionally. Just don't drink it too hard. This includes eating watermelon in summer. Don't scoop up half the watermelon in one go. There's no problem at all if you eat it several times.

As for whether coffee and strong tea can be drunk, which are the most frequently asked questions, opinions have actually changed a lot in recent years. Guidelines from more than ten years ago did recommend avoiding it as much as possible, but new research in recent years has found that as long as you are not particularly sensitive to caffeine, drinking 1-2 cups of coffee a day and occasionally drinking a cup of strong tea to relieve fatigue will not increase the risk of attacks at all. On the contrary, some patients who drink coffee all year round will experience caffeine withdrawal reactions, headaches, and insomnia after quitting suddenly, which in turn triggers attacks. Of course, if you can’t sleep all night long after drinking half a cup of coffee, and your hands are shaking and your heart is flustered, then definitely don’t do it. After all, poor sleep itself is a major cause of epileptic seizures.

The thing I say most often to patients’ families is, don’t make patients special. During the Chinese New Year, the whole family had hot pot, and I specially cooked a bowl of clear water without salt or spicy for him. ； When friends gather for dinner and everyone drinks, only handing him a glass of boiled water will make the patient feel that he is an alien, depressed or excited, which makes it easier to induce attacks. As long as you don't touch alcohol or drink too much water, everything else will be the same as normal people. You will have a stable mentality and adequate nutrition, which is more effective than any rigid taboo list.

To put it bluntly, the dietary taboos for epilepsy are really not that complicated. Don’t be intimidated by the “Top Ten Fasting Lists” on the Internet. Stick to the three core red lines and follow your body’s feelings for the rest. Eat when you feel comfortable and stop when you feel uncomfortable. It’s that simple.