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Ketogenic Diet

By Professor Helen Cross

The Ketogenic diet, a high fat diet designed to mimic the effect on the body of starvation, has been shown to be effective in the treatment of drug resistant epilepsy. It was determined in the early part of the last century that starvation could in fact benefit seizures, with the realisation that this was impractical. A diet where the main energy source was indeed fat also produces ketones and was found to be effective against seizures. A recently completed randomised controlled trial at Great Ormond Street Hospital (GOH) and the National Centre for Young People with Epilepsy (NCYPE) has shown the diet to be more effective than no change in children resistant to anti-convulsant medication. Further, they compared two ways of giving the diet, classical and medium chain triglyceride diets, and found no difference in effect.

The diet cannot be seen to be a "natural diet". It can have side effects like any anti-epileptic drug and has to be monitored. It also cannot just be prescribed; the diet has to be calculated appropriately for each individual child and therefore requires a high degree of dietetic resource. This aside, any child who has failed two anti-convulsant medications in the treatment of their epilepsy could be considered to be possibly suitable for the diet should the family and caring physician both agree.

Other less strict ways are being considered with regards to giving the diet, such as the modified Atkins diet and the low glycemic index diet. However, in children, these should still be discussed and monitored by a dietician.