The use of ketogenic diet in therapy of drug-resistant epilepsies – current state of knowledge

Introduction and Objective. Epilepsy is a neurological disorder where a desynchronization occurs in the discharge of neurons of specific brain areas. Clinically, this manifests as epileptic seizures with possible disturbances of consciousness. Therapy of epilepsy is based on pharmacotherapy, but in cases of drug resistance, alternative methods, such as ketogenic diet (KD) should be explored. The aim of this review is to present the current state of knowledge concerning the use of KD in epilepsy and the clinical results of such therapy. Review Methods. PubMed, PubMed Central and Google Scholar databases were searched using key words related to epilepsy, ketogenic diet, metabolic mechanisms of ketosis and antiepileptic effects of ketone bodies. Articles and book sections in English were searched and reviewed. Articles were selected after analyzing abstracts and those that matched and described the topic in a proper way were used. The types of articles included prospective studies, retrospective studies, reviews and meta-analyses. Brief description of the state of knowledge. From the initial search, 20 articles strictly concerning the KD mechanisms of action, its antiepileptic effects and the results of the therapy conducted were retrieved for final analysis. Available data provide the information specifically on the definition of KD, adverse effects, anti-seizure mechanisms and therapy results mainly from recent years. KD is currently being used as an alternative therapy in drug-resistant epilepsies. The reduction in seizures after its use averages about 50%, and some studies have shown up to 90% effectiveness in seizure reduction. Summary. Understanding the mechanisms of brain metabolism allowed the use of KD in the treatment of epilepsy and other neuropsychiatric diseases. The results of the therapy appear to be satisfactory and provide hope for future epilepsy therapy.