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Ketogenic Diet for Refractory Pediatric Seizures

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Dr. Feldman reports no financial relationships relevant to this field of study.

SOURCE: Jagadish S, Payne ET, Wong-Kisiel L, et al. The ketogenic and modified Atkins diet therapy for children with refractory epilepsy of genetic etiology. Pediatr Neurol 2019;94:32-37.

SUMMARY POINTS

* This retrospective investigation looked at decrease in seizure frequency in 59 children with seizures of genetic etiology who were treated with a low-carb diet (modified Atkins diet or ketogenic diet).* A reduction in seizures > 50% was measured periodically, beginning at one month into the study and ending at two years (24 months).* Response rates to this diet for refractory seizures in children are about 50%; in this population, response rates were 63% at the end of the first month and showed a gradual decline to 41% at the end of the study (24 months.)* Adverse effects included hypoglycemia, vomiting, and refusal to feed. At study conclusion, 47% of the study group remained on the diet.

“The keto craze is hitting the mainstream,” proclaimed a banner headline on CNN in September 2018. 1 “The high-fat, low-carb diet has swept Hollywood,” noted The New York Times in March 2019, pointing to weight loss and energy gain as the main attraction of this diet. 2 All of the hype and recent attention may lead to the idea that the ketogenic diet (KD) is a new phenomenon.

The medical world, however, has been aware and interested in dietary control of disease since the ancient time of Hippocrates. 3 More recently, medical interest in the benefits of a diet mimicking a fasting state and specifically promoting ketosis emerged in the early 1900s. Based on a theory that a toxin released in the intestines causes seizures and that a fasting state could help free the body of these poisons, most of the early 20th...