How can the Keto-Diet support seizure reduction?

Ketogenic diet therapy (KDT) is a high-fat, low carbohydrate, and moderate-protein diet that has been used for the dietary management of children and adults with drug-resistant (refractory epilepsy) for more than a century. International expert consensus guidelines for the Keto-Diet recommend that after 2-3 failed anti-epileptic drugs (AEDs) KDT should be trialed6. The benefits of Keto-Diet have been proven in clinical trials >50% of patients experienced >50% reduction in seizures after starting the diet.

A high level review of all clinical trials exploring the efficacy of the Keto-Diet on seizure reduction was published in 20203 which showed that >50% of patients experienced >50% reduction in seizures after starting Keto-Diet3. In addition a review study looking at the effect of KDT on seizure reduction in infants <1 years found that approximately 60% infants achieved ≥50% seizure reduction, with 28% becoming seizure-free2.

However given its efficacy, expert consensus guidelines recommend that KDT should be considered earlier as an option for epilepsy after 2-3 anti-seizure medications have failed to minimize or control seizures2.

KDT is also the option of first choice for 2 distinct disorders of brain energy metabolism:
Glut1DS and PDHD2.

  1. Lyons L, Schoeler NE, Langan D, Cross JH. Use of ketogenic diet therapy in infants with epilepsy: A systematic review and meta-analysis. Epilepsia. 2020;61:1261–1281
  2. Kossoff E, et al. Optimal Clinical Management of Children Receiving Dietary Therapies for Epilepsy: Updated Recommendations of the International Ketogenic Diet Study Group. Epilepsia Open. 2018;3(2):175-92.
  3. Martin-McGill KJ et al. Ketogenic diets for drug-resistant epilepsy. Cochrane Database of Systematic Reviews 2020, Issue 6. Art. No.: CD001903. DOI: 10.1002/14651858.CD001903.pub5

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