Ketogenic diet for epilepsy treatment

Abstract

The ketogenic diet (KD), a high-fat, low-carbohydrate, and adequate-protein diet is an established, effective nonpharmacologic treatment option for intractable childhood epilepsy. The KD was developed in 1921 and even though it has been increasingly used worldwide in the past decade, many neurologists are not familiar with this therapeutic approach. In the past few years, alternative and more flexible KD variants have been developed to make the treatment easier and more palatable while reducing side effects and making it available to larger group of refractory epilepsy patients. This review summarizes the history of the KD and the principles and efficacy of the classic ketogenic diet, medium-chain triglyceride(s) (MCT) ketogenic diet, modified Atkins diet, and low glycemic index treatment.

Patient with Recurrent Glioblastoma Responding Favorably to Ketogenic Diet Combined with Intranasal Delivery of Perillyl Alcohol: A Case Report and Literature Review

“…2,36 Moreover, our results demonstrating a reduction in the frequency of seizure episodes in a patient with recurrent GBM following combined administration of the KD and intranasal POH are consistent with an increasing body of data demonstrating the value of using a KD to manage patients with intractable epilepsy. 12,37 Importantly, seizures are often refractory to medication in patients with GBM, and can persist after surgery. 8 This is a major concern in the management of patients with GBM, as epilepsy develops in 29-49% of the patients diagnosed with brain tumors.…”

Dieta cetogénica: mecanismos en el control de la epilepsia refractaria

“…-370 AC.) (Sampaio, 2016 (Wilder, 1921;Kossoff & Hartman, 2012). En el 1938, con la inclusión de la fenitoína como fármaco anticonvulsivante, disminuye el interés de la comunidad científica y clínica en la DC, reapareciendo el interés por su efectividad en la década de 1990.…”

“…Por otro lado, es conveniente destacar que existen numerosos efectos adversos asociados a la DC de TCM, tales como, diarrea, vómitos y dolor abdominal, es por esto que la DC de TCM ha sufrido modificaciones para hacerla más tolerable, modificando el porcentaje de TCM, llegando a 30 % de TCM y 30 % de triglicéridos de cadena larga. De esta forma, se busca incrementar progresivamente el componente de interés hasta los máximos niveles tolerados (Sampaio, 2016). En relación con la eficacia que se ha visto en la DC de TCM y a los numerosos efectos adversos del ácido valproico (ácido graso de cadena corta y uno de los principales anticonvulsivantes usados en un amplio espectro de crisis epilépticas), como teratogenicidad y hepatotoxicidad, se ha estado investigando en nuevas alternativas terapéuticas.…”

Nutritional aspects of neurological diseases

“…U slučaju neefikasnosti antiepileptične terapije kod dece, preporučuje se ketogena dijeta (KD), koja se eksperimentalno koristi od 1921. godine. KD pokazuje ohrabrujuće rezultate kod epiletične dece -kod oko trećine dolazi do potpunog povlačenja, a kod trećine do delimičnog povlačenja napada (48).…”