What is the role of a ketogenic diet in the treatment of epilepsy?

Updated: May 30, 2019
  • Author: David Y Ko, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

The ketogenic diet, which relies heavily on the use of fat, such as hydrogenated vegetable oil shortening (eg, Crisco), has a role in the treatment of children with severe epilepsy. Support for the efficacy of these diets comes from large observational studies rather than from randomized, controlled trials. [61]

Although this diet is unquestionably effective in some refractory cases of seizure, a ketogenic diet is difficult to maintain; less than 10% of patients continue the diet after a year. Furthermore, any small carbohydrate intake (eg, lollypop, piece of candy) resets ketone metabolism for 2 weeks, thereby eliminating antiseizure efficacy. Consequently, some authors do not consider using this treatment in teenagers or adults unless all of the patient’s caloric intake is being delivered by means of a gastric tube.


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