Ketogenic diets in the treatment of epilepsy.

Epilepsy (a proneness to recurrent seizures) is the most common serious neurological disorder, with an incidence of around 40-70 cases per 100,000 population in developed countries, and a lifetime risk of 1-3%.(1-3) Seizures have been reported to cease on absolute fasting, and early studies suggested that a diet high in fat and low in carbohydrate would produce similar conditions to fasting; the anticonvulsant effect was attributed to the production of ketones.(2) The ketogenic diet was introduced as a treatment for epilepsy in the 1920s, but its use waned with the introduction of phenytoin and other antiepileptic drugs.(2-4) However, around 30% of patients continue to have seizures while taking one or more antiepileptic drugs, and some patients have significant unwanted effects with such medication.(1,2) During the past two decades, there has been a renaissance of interest in dietary therapy.(2) Here, we focus on the use of ketogenic diets in the treatment of epilepsy.