The ketogenic diet for refractory epilepsy

Despite the availability of various anti-epileptic drugs, seizures can be particularly challenging to treat.¹Stafstrom C, et al. Epilepsy and the ketogenic diet. 2004. Humana Press. Totawa. Published on 2004 Whilst prognosis for the majority of patients is good, 30% to 40% of patients do not achieve remission despite treatment with anti-epileptic medication.²Kwan et al. P, et al. N Engl J Med. Published on 2000:342;314-319. There has been significant amount of research in recent years on alternative treatments for these ‘difficult-to-treat’ patients, with a growing interest in the benefits of dietary interventions. Dietary management via the ketogenic diet can offer an effective way to reduce the number of seizures and, in some cases, can lead to seizure remission.³Freeman J J, et al. DOI: Pediatrics.  Published on 2007;119;535-543. ,⁴Neal EG,  et al. Lancet Neurol,  Published on 2008;7:500-506. ,⁵Keene DL, Ped Neurol. Published on 2006;35(1):1-3. ,⁶Henderson GB, et al. J Child Neurol. Published on 2006;21(3):193-198. ,⁷Kossoff EH, et al. Epilepsia. Published on 2009:50(2)304-317

The ketogenic diet is a high fat, low carbohydrate diet, which ensures adequate protein for growth and development. The ketogenic diet is thought to simulate the metabolism of fasting, known for its effects in epilepsy. Patients who follow a ketogenic diet get their energy mainly from metabolising the fat in their diets, rather than from glucose, which is the more common source of energy.⁸Clanton RM, et al. Amino Acids. Published on 2017;49(1):1-20. ,⁹Kim DY and Rho JM,  Curr Opin Clin Nutr Metab Care . Published on 2008;11(2):113-120 Based on the existing evidence, experts have made recommendations that ketogenic diet therapy can be highly efficacious and should be seriously considered as a management option early in the management of drug-resistant epilepsy.