Ketogenic diet for epilepsy

Levy RG, Cooper PP

Published Online:

January 20, 2010

No evidence from randomized controlled trials to support ketogenic diets, but observational studies do lend some support for a beneficial effect.

Epilepsy is a disorder where recurrent seizures are caused by abnormal electrical discharges from the brain. Most seizures can be controlled by a single antiepileptic drug but sometimes seizures develop which are resistant to these drugs. The ketogenic diet was introduced prior to the advent of these modern drugs and continues to be used in many centres. Our search found no randomized controlled trials, however a number of observational studies lend some support for a beneficial effect.

Abstract (click to read)

Background:

The ketogenic diet is a diet high in fat but low in carbohydrate and it is suggested that this diet reduces seizure frequency. Currently, this diet is used mainly for children who continue to have seizures despite treatment with antiepileptic drugs.

Objectives:

To overview the evidence from randomized controlled trials regarding the effects of ketogenic diets.

Search strategy:

We searched the Cochrane Epilepsy Group's Specialized Register (March 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2005), MEDLINE (1966 to March 2005) and EMBASE (1980 to March 2003). Details of the strategies used are outlined in No language restrictions were imposed. We checked the reference lists of retrieved studies for additional reports of relevant studies.

Selection criteria:

Randomized controlled trials of ketogenic diets for people with epilepsy.

Data collection and analysis:

We planned for two review authors to independently apply inclusion criteria and extract data.

Main results:

No randomized controlled trials were found.

Authors' conclusions:

There is no reliable evidence from randomized controlled trials to support the use of ketogenic diets for people with epilepsy. There are large observational studies, some prospective, suggesting an effect on seizures. These effects need validating in randomized controlled trials. For those with a difficult epilepsy on multiple antiepileptic drugs, we consider the ketogenic diet a possible option.

This record should be cited as:

Levy RG, Cooper PP. Ketogenic diet for epilepsy. Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD001903. DOI: 10.1002/14651858.CD001903

Assessed as up to date:

March 26, 2005

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Primary Review Group:

Epilepsy Group

Health topics:

Neurology > Epilepsy > Diet

Complementary & alternative medicine > Neurology > Epilepsy

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