This diet focuses on limiting the amount of carbohydrate while encouraging fat consumption. Because KD is not a physiological diet, it is necessary to recognize and closely manage AE Kossoff et al. Arch Intern Med Chic. He proposed that the KD should be tried in a series of patients with epilepsy and suggested that it should be as effective as fasting and could be maintained for a much longer period of time 8. Ketogenic diet for infantile spasms refractory to first-line treatments: an open prospective study. How does the diet work? Mechanism of action Despite nearly a century of use, the mechanisms underlying the clinical efficacy of the ketogenic diet remain unknown.
The ketogenic diet KD, a high-fat, low-carbohydrate, and adequate-protein diet is an established, effective nonpharmacologic treatment option for intractable childhood epilepsy. In the past few years, alternative and more flexible KD variants have been developed to make the treatment easier and more palatable while reducing side effects and making it available to larger group of refractory epilepsy patients. This review summarizes the history of the KD and the principles and efficacy of the classic ketogenic diet, medium-chain triglyceride s MCT ketogenic diet, modified Atkins diet, and low glycemic index treatment. The ketogenic diet KD, a high-fat, low-carbohydrate, adequate-protein diet is an established, effective nonpharmacologic treatment for children with intractable epilepsy, which is defined as epilepsy that failed to respond to three or more AEDs. This therapeutic approach can be a reasonable option for adults who also have intractable epilepsy and who are not surgical candidates. The classic KD is tightly controlled, specifically calculated for each patient, and formulated using different protocols in different countries, occasionally with significant variations in its administration. The diet should be implemented in a multidisciplinary way under the supervision of a physician and dietitian 4. The side effects should be monitored and they include, in the short-term, acidosis, hypoglycemia, vomiting, obstipation, diarrhea, and gastroesophageal reflux. The long-term side effects usually occur after three months and consist of hyperlipidemia, constipation, renal calculi, growth failure, bone health, and deficits of vitamins, minerals and trace elements 4. Since the Hippocratic era BC— BC, fasting has been recognized as a therapeutic treatment for epilepsy.
Learn about our expanded patient care options and visitor guidelines. One of the oldest treatments for epilepsy is the classic ketogenic diet, which involves consuming high-fat foods and very few carbohydrates. Johns Hopkins is a longstanding pioneer in this mode of therapy. In order to be successful, this therapy calls for strict compliance and plenty of patience, especially in the beginning. Most important, patients with epilepsy should only use the diet with the support of a knowledgeable ketogenic diet team, including a doctor and a licensed dietitian who can correctly calculate and monitor the diet for each individual. We are one of the premiere centers in the world for clinical and research expertise on the ketogenic diet, having treated over 1, children with this approach. We usually see the child for a one-hour office visit before admission to the ketogenic diet program. We admit approximately four children ranging from infants to adolescents each month to participate in the therapeutic ketogenic diet program. New patients take part in a 3-day orientation Monday through Wednesday that starts the child on the diet and provides education for the family. After that, we follow up with the patients in our clinic every one to three months.