TV MOVIE PROMOTES DIET FOR EPILEPSY : HIGH-FAT REGIMEN HELPS SOME PATIENTS.

Byline: Eric Leach Daily News Staff Writer

Two Los Angeles doctors who specialize in the treatment of brain disorders hope an ABC television movie tonight, ``First Do No Harm'' starring Meryl Streep, will raise awareness of a high-fat diet being used to treat epilepsy in some children.

But they caution that the controversial diet is appropriate only in certain cases and must be administered exactly as prescribed.

``Children on the ketogenic diet drink lots of whole cream and eat lots of bacon and eggs. I've had it myself. It's quite tasty,'' said neurologist William Sutherling of Sherman Oaks, who is director of Good Samaritan Hospital's Epilepsy and Brain Mapping Center.

Sutherling and his wife, Jeri, a nurse in an intensive care unit, were medical consultants for the television movie, scheduled for 9 p.m.

Streep, a two-time Oscar winner, collaborated with the movie's director, Jim Abrahams, whose son suffered epileptic seizures until a ketogenic diet controlled them. After drugs and brain surgery failed, Abrahams and his wife turned to the diet as a last resort.

``Jim was a tremendous advocate of it for the care of his son. He's a very bright individual and reviewed all the medical literature,'' said Sutherling, who stressed that ``heavily committed parental involvement is essential.''

The film tells the story of a mother, played by Streep, who overcomes doctors' resistance to the diet and uses it to help her son.

The diet, which has been refined at Johns Hopkins University in Baltimore, was developed in the 1920s before modern epilepsy drugs were available.

Good Samaritan Hospital and UCLA Medical Center are two of 17 places in the United States certified by Johns Hopkins to offer the diet, which induces fat metabolism that produces ketosis found to promote seizure control.

The diet works only for some children and should be used only if more conventional treatments are not working, epilepsy experts say.

``This diet is for children who are not improving with medication or for children who have major unwanted side effects with the medication they take,'' Sutherling said.

Jerome Engel Jr., professor of neurology and neurobiology at UCLA and director of UCLA's Seizure Disorder Center, also said drug treatment is preferable if it is effective.

``If the seizures can be treated with drugs, that's the easiest way to do it. If they can't, the ketogenic diet is a reasonable way to treat it,'' Engel said.

``There is no doubt that (the ketogenic diet) seems to be very effective in some patients,'' he said. ``The question comes in whether it should be preferred to other approaches that are more benign.''

A five-day hospitalization is required at the start of the diet, when children are put on a two-day fast.

Where a normal diet consists of about 50 percent carbohydrates, 30 percent fat, and 20 percent protein, the typical ketogenic diet may contain 90 percent fat, 6 percent protein and only 4 percent carbohydrates.

Of the children who follow the diet precisely, 33 percent stop having any seizures, and an additional 38 percent get a significant reduction in seizures, authorities say.

``Children are often weaned from the diet after about two years and, if they were seizure-free while on the diet, remain seizure-free after that,'' Sutherling said.

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Photo: Neurologist William Sutherling of Sherman Oaks, who heads the Epilepsy and Brain Mapping Center at Good Samaritan Hospital, approves of a high-fat diet for some children with epilepsy.

Gus Ruelas/Daily News