Ketogenic Diet and Drug-Resistant Epilepsy

Abstract

The ketogenic diet is a high-fat, low-carbohydrate, and restricted protein diet that is used in children with drug-resistant epilepsy. Over the past years, there has been a focus on the use of ketogenic dietary therapy in different types of epilepsy and epilepsy syndromes as well as etiologies and as an alternative treatment in refractory and super refractory status epilepticus. Ketogenic dietary therapies probably have multiple mechanisms of action that may work synergistically. It has been shown that children with Angelman syndrome, Dravet syndrome, febrile infection-related epilepsy syndrome, infantile epileptic spasms, epilepsy with myoclonic-atonic seizures, and tuberous sclerosis complex respond particularly well to the diet. In many patients, the diet improves not only epilepsy but also cognition and behavior. Current evidence shows that ketogenic dietary therapies should be used earlier in the treatment algorithm for several syndromes.