Ketogenic Diets for the Treatment of Epilepsy

Fasting has been recognized to attenuate seizures for centuries, and in the last century dietary therapies have been formulated to treat epilepsy by inducing ketosis, thereby mimicking the state of starvation. A variety of ketogenic diets have been studied, including the classic ketogenic diet (KD), the medium-chain triglyceride diet (MCT), the modified Atkins diet (MAD), and the low glycemic index treatment (LGIT). All result in a greater than 50% reduction in seizure frequency in approximately half of patients but require close neurologic and dietician follow-up. Traditionally, dietary therapies have been reserved for refractory epilepsy and certain metabolic disorders; however, current work is evaluating a role for ketogenic diets for status epilepticus, as an early intervention in childhood epilepsy, and even in other neurologic disorders.