The ketogenic diet for refractory epilepsy

Despite the availability of various anti-epileptic drugs, seizures can be particularly challenging to treat.1 Whilst prognosis for the majority of patients is good, 30% to 40% of patients do not achieve remission despite treatment with anti-epileptic medication.2 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.3, 4, 5, 6, 7

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.8,9 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.7

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