Prospects of the therapeutic approaches of ketogenic diet in epilepsy management

Abstract

The ketogenic diet (KD) is a low-carbohydrate, high-fat diet. For many patients with uncontrolled epilepsy, KD treatments provide a proven non-pharmacological therapy alternative. This is particularly relevant for children with particular epilepsy syndromes and metabolic abnormalities. The aim of this study was to provide a broad overview of the KD, covering the therapeutic effects, relevant mechanisms, and clinical evidence underlying the implementation of the KD in epilepsy management. The study found that KD efficacy is syndrome-specific and patient-dependent. This diet can lower seizure frequency and, in certain cases, can provide prolonged seizure control when antiseizure medication is no longer effective. Their usage in epilepsy disorders, such as infantile spasms, Dravet syndrome, Lennox-Gastaut syndrome, and other refractory epileptic encephalopathies is most well supported. Restrictive dietary adherence, gastrointestinal and metabolic side effects, nutritional inadequacies, the risk of dyslipidemia and nephrolithiasis, and the requirement for close multidisciplinary monitoring are some of the primary limitations with KD therapies. Therefore, rather than being a general therapeutic approach, KD treatments should be used under specialized supervision and taken into consideration as part of a tailored treatment strategy for drug-resistant epilepsy.