Ketogenic Diets for Pediatric Epilepsy Treatment

The ketogenic diet is a medical diet that contains low carbohydrate, high fat, and moderate protein content. The diet is decided to induce the body metabolism into the metabolic state called ketosis.

The ketogenic diet has multiple mechanisms to alleviate and stop seizures including, but not limited to, the following:

• Provide an alternative energy fuel to the brain and increase brain energy production, which result in the brain becoming more “resilient” to seizures.
• Alter the chemicals (neurotransmitters) in the brain and reduce brain excitation.
• Reduce inflammation in the brain.
• Possible neuroprotection (protect against loss of brain cells)
• Potentially change gene expression in the brain through the epigenetic process which may result in a sustained benefit and efficacy in seizure control.

Because seizures and epilepsy are different in each individual person, the efficacy of the dietary therapy may not be the same for everyone. However, studies have shown that approximately 15-20% of patients with epilepsy, who do not respond to medications, can become seizure-free on the ketogenic diet, and approximately one-third of patients with drug-resistant epilepsy can have > 90% seizure reduction in frequency.

Most people with epilepsy can benefit from the ketogenic diet therapy, especially ones whose seizures do not respond to medications. Additionally, patients with certain epilepsy diagnoses may have a significant and remarkable response to the ketogenic diet and should consider the therapy early, such as:

• Glucose transporter 1 deficiency syndrome
• Epilepsy with myoclonic-atonic seizures (Doose syndrome)
• Infantile spasms
• Developmental and Epileptic Encephalopathy (DEE)
• Infants with epilepsy
• Epilepsy due to a genetic disorder