Effects of ketogenic diet on epilepsy in children

Introduction and Objective. The Ketogenic Diet (KD) is a diet consisting of the restriction of protein, carbohydrates, and fluids. KD is used in the treatment of epilepsy and is currently the foundation for a therapeutic approach for drug-resistant epilepsy. The aim of the study was to review the current literature, and provide information about the application of the Ketogenic Diet in children with treatment-resistant epilepsy. Review Methods. Literature in English and Polish was reviewed via PubMed, Google Scholar and The Wiley Library. 250 publications were taken into consideration from which 50 were selected: meta-analysis publications, review articles, randomised controlled trials, and research articles, with emphasis on the most recent information on the topic. About 88% of the publications selected were published in 2017 or later. Brief description of the state of knowledge. Taking into consideration randomised controlled trials of 472 children with drug-resistant epilepsy, the results indicate a statistically significant reduction in seizure frequency (SFR ≥ 50%) in the KD-treated group, compared to the control group. The greatest improvement was observed in patients following a KD with a ketogenic ratio of 2.5/3:1 and the optimal time to initiate KD being before the age of two years. The highest chance of success was noted in the infant population in whom a complete elimination of epileptic seizures is possible. Summary. Randomised controlled trials indicate that the Ketogenic Diet has a positive effect on reducing the occurrence of seizures in paediatric patients with drug-resistant epilepsy.