Decreased relative efficacy of the ketogenic diet for children with surgically approachable epilepsy

Rebecca S. Stainman, Zahava Turner, James E. Rubenstein, Eric H. Kossoff

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Purpose: In children with intractable, surgically approachable epilepsy, the ketogenic diet is often perceived as less efficacious than surgery. Methods: A retrospective chart review was performed of 554 children started on the ketogenic diet since 1994. Forty-five children were identified as surgical candidates, with at least 2 focal routine EEGs, ictal video-EEG, and corresponding focal neuroimaging findings, of whom 24 eventually had resective surgery and were followed subsequently. A comparison cohort group was also created of 45 children matched for age and seizure frequency that received the diet but were not surgical candidates (multifocal or generalized seizures). Results: Of the 24 children who received both dietary and surgical therapies, there was a higher likelihood after 6 months of both >90% seizure reduction (71% versus 17%) and seizure freedom (63% versus 0%) following surgery, both p < 0.0001. Similarly, the 45 cohort children who were not surgical candidates were more likely to be seizure-free (29% versus 13%, p = 0.041) and remained on the diet for shorter duration (10 months versus 18 months, p = 0.035) compared to the surgical group. Conclusion: Children with surgically approachable epilepsy do respond to the diet, but are more likely to be seizure-free following surgery.

Original languageEnglish (US)
Pages (from-to)615-619
Number of pages5
Issue number7
StatePublished - Oct 2007


  • Children
  • Epilepsy
  • Ketogenic diet
  • Seizure freedom
  • Surgery

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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