Review article
The role for ketogenic diets in epilepsy and status epilepticus in adults

https://doi.org/10.1016/j.cnp.2017.06.001Get rights and content
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open access

Highlights

Ketogenic diets offer adjunctive therapy for chronic epilepsy and refractory status epilepticus.

Studies support feasibility and efficacy of the classic ketogenic diet and its variants in adults.

Potential complications and side effects of diet therapy are often preventable and manageable.

Strategies are needed to improve diet adherence.

Abstract

Ketogenic diet (KD) therapies are high fat, low carbohydrate diets designed to mimic a fasting state. Although studies demonstrate KD’s success in reducing seizures stretching back nearly a century, the last 25 years have seen a resurgence in diet therapy for the management of drug-resistant epilepsy in children as well as adults. With ≥50% seizure reduction efficacy rates in adults of 22–55% for the classic KD and 12–67% for the modified Atkins diet, diet therapy may be in many instances comparable to a trial of an additional anti-epileptic medication and potentially with fewer side effects and other health benefits. Moreover, ketogenic diets offer promising new adjunctive strategies for the treatment of acute status epilepticus in the intensive care setting. Here, we review the efficacy and utility of ketogenic diets for the management of chronic epilepsy and refractory status epilepticus in adults and offer practical guidelines for diet implementation and maintenance.

Keywords

Ketogenic diet
Modified Atkins diet
Epilepsy
Drug-resistant epilepsy
Refractory status epilepticus