Hepatic Dysfunction as a Complication of Combined Valproate and Ketogenic Diet

Clare E. Stevens, Zahava Turner, Eric H. Kossoff

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background The ketogenic diet has long been shown to be an effective therapy for children with medication-refractory seizures. Most complications of the ketogenic diet include short-lived gastrointestinal disturbances, acidosis, and dyslipidemia. Hepatic dysfunction and pancreatitis are among the less common but more serious complications of the ketogenic diet. Many patients on the ketogenic diet receive adjunct treatment with an anticonvulsant drug, and valproate is frequently used. Methods and Results We describe a child who developed hepatic dysfunction in association with the combined use of valproate and the ketogenic diet. After stopping the valproate and then restarting the ketogenic diet, her liver enzymes normalized, and she was able to achieve markedly improved seizure control and quality of life. Conclusions Although caution should be advised when using both treatments simultaneously, the development of hepatic dysfunction should not preclude continuation of the ketogenic diet, as the hepatotoxic effects may be completely reversed once the valproate is stopped.

Original languageEnglish (US)
Pages (from-to)82-84
Number of pages3
JournalPediatric Neurology
StatePublished - Jan 1 2016


  • complications
  • epilepsy
  • hepatitis
  • ketosis
  • liver
  • side effects
  • valproic acid

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neurology
  • Developmental Neuroscience
  • Clinical Neurology


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