Ketogenic Diet and Epilepsy: What We Know So Far

Key Takeaways from the 2019 Review:

1. Effectiveness

• The ketogenic diet (KD) is a well-established, non-pharmacological treatment for drug-resistant (refractory) epilepsy.
• In children: Studies showed >50% seizure reduction in a significant percentage of patients, with some achieving seizure freedom.
• It works for various epilepsy types, including focal, generalized, and specific syndromes (e.g., infantile spasms, Lennox-Gastaut).
• Benefits were also noted in adults, though fewer studies existed at the time.

2. How It Works (Mechanisms)

• Shifts brain energy source from glucose to ketone bodies.
• Reduces neuronal excitability.
• Increases GABA (inhibitory neurotransmitter) and decreases glutamate (excitatory).
• Anti-inflammatory effects.
• Improves mitochondrial function and energy production in brain cells.

3. Variants of the Diet

• Classic Ketogenic Diet (high fat, very low carb) — most studied.
• Modified Atkins Diet (MAD) — less restrictive, better tolerated, especially for adults and older children.
• Low Glycemic Index Treatment (LGIT) — allows more carbohydrates from low-GI sources.

4. Side Effects Common but often manageable:

• Constipation
• Kidney stones
• Growth issues in children (if long-term)
• Nutrient deficiencies (requires supplementation)
• Lipid profile changes

5. Conclusion in 2019 The authors concluded that the ketogenic diet is a safe and effective option for many patients with refractory epilepsy, especially when medications fail. They recommended it as an important therapeutic tool, ideally managed by experienced medical teams

Full Paper Links:

• Full Text (Frontiers in Neuroscience)
• PubMed Abstract
• PMC Full Text