Ketogenic diets for drug-resistant epilepsy

Abstract

Background Ketogenic diets (KDs), being high in fat and low in carbohydrates, have been suggested to reduce seizure frequency in people with epilepsy. At present, such diets are mainly recommended for children who continue to have seizures despite treatment with antiepileptic drugs (AEDs) (drug-resistant epilepsy). Recently, there has been interest in less restrictive KDs, including the modified Atkins diet (MAD), and the use of these diets has extended into adult practice. This is an update of a review first published in 2003 and last updated in 2016. Objectives To assess the e ects of KDs for drug-resistant epilepsy by reviewing the evidence from randomised controlled trials.

Diet-induced ketosis in adult patients with subacute acquired brain injury: a feasibility study

“…There is still little safety data on ketogenic interventions in ABI patients. The SARs and ARs in previous acute ABI studies ( 9 , 16–19 ) and in this subacute ABI study are congruent with the epilepsy literature ( 46 , 47 ). More research is needed to be able to conclude if ketogenic interventions are safe in acute and subacute phases of ABI.…”

Diet-induced ketosis in adult patients with subacute acquired brain injury: a feasibility study

“…There is still little safety data on ketogenic interventions in ABI patients. The SARs and ARs in previous acute ABI studies ( 9 , 16–19 ) and in this subacute ABI study are congruent with the epilepsy literature ( 46 , 47 ). More research is needed to be able to conclude if ketogenic interventions are safe in acute and subacute phases of ABI.…”

Effectiveness and safety analysis of ketogenic diet therapy for drug-resistant epilepsy caused by structural pathology

“…Most of these symptoms were mild, and only one patient discontinued KD treatment due to poor appetite. Additionally, one patient developed a rash, one had bladder sediment, and another developed gallstone, all of which resolved upon follow-up examinations, consistent with findings from previous studies ( 30 – 32 ).…”

Efficacy and Safety of the Ketogenic Diet for Mitochondrial Disease With Epilepsy: A Prospective, Open-labeled, Controlled Study

“…Two other studies with mitochondrial respiratory chain defects in epilepsy patients found that 71–75% of participants experienced >50% seizure reduction after KD intervention ( 17 , 18 ). The response rates of mitochondrial diseases in this study were similar to those in refractory epilepsy studies, in which response rates for the KD and control groups were 35–56.1% and 6–18.2%, respectively ( 24 – 31 ). In addition, the International League against Epilepsy (ILAE) also attests to considerable response rates (70%) of KD to epilepsy and recommended this therapy in its guidelines ( 32 ).…”

Diet-induced ketosis in adult patients with subacute acquired brain injury: a feasibility study

“…There is still little safety data on ketogenic interventions in ABI patients. The SARs and ARs in previous acute ABI studies ( 9 , 16–19 ) and in this subacute ABI study are congruent with the epilepsy literature ( 46 , 47 ). More research is needed to be able to conclude if ketogenic interventions are safe in acute and subacute phases of ABI.…”

Effectiveness and safety analysis of ketogenic diet therapy for drug-resistant epilepsy caused by structural pathology

“…Most of these symptoms were mild, and only one patient discontinued KD treatment due to poor appetite. Additionally, one patient developed a rash, one had bladder sediment, and another developed gallstone, all of which resolved upon follow-up examinations, consistent with findings from previous studies ( 30 – 32 ).…”

Efficacy and Safety of the Ketogenic Diet for Mitochondrial Disease With Epilepsy: A Prospective, Open-labeled, Controlled Study

“…Two other studies with mitochondrial respiratory chain defects in epilepsy patients found that 71–75% of participants experienced >50% seizure reduction after KD intervention ( 17 , 18 ). The response rates of mitochondrial diseases in this study were similar to those in refractory epilepsy studies, in which response rates for the KD and control groups were 35–56.1% and 6–18.2%, respectively ( 24 – 31 ). In addition, the International League against Epilepsy (ILAE) also attests to considerable response rates (70%) of KD to epilepsy and recommended this therapy in its guidelines ( 32 ).…”

Diet-induced ketosis in adult patients with subacute acquired brain injury: a feasibility study

“…There is still little safety data on ketogenic interventions in ABI patients. The SARs and ARs in previous acute ABI studies ( 9 , 16–19 ) and in this subacute ABI study are congruent with the epilepsy literature ( 46 , 47 ). More research is needed to be able to conclude if ketogenic interventions are safe in acute and subacute phases of ABI.…”

Effectiveness and safety analysis of ketogenic diet therapy for drug-resistant epilepsy caused by structural pathology

“…Most of these symptoms were mild, and only one patient discontinued KD treatment due to poor appetite. Additionally, one patient developed a rash, one had bladder sediment, and another developed gallstone, all of which resolved upon follow-up examinations, consistent with findings from previous studies ( 30 – 32 ).…”

Efficacy and Safety of the Ketogenic Diet for Mitochondrial Disease With Epilepsy: A Prospective, Open-labeled, Controlled Study

“…Two other studies with mitochondrial respiratory chain defects in epilepsy patients found that 71–75% of participants experienced >50% seizure reduction after KD intervention ( 17 , 18 ). The response rates of mitochondrial diseases in this study were similar to those in refractory epilepsy studies, in which response rates for the KD and control groups were 35–56.1% and 6–18.2%, respectively ( 24 – 31 ). In addition, the International League against Epilepsy (ILAE) also attests to considerable response rates (70%) of KD to epilepsy and recommended this therapy in its guidelines ( 32 ).…”