Epilepsy

The ketogenic diet has been used as a treatment for infantile epilepsy since the beginning of the 1920s, but after the introduction of antiepileptic drugs the diet was gradually abandoned in favour of medication. In recent years, its usefulness as a treatment for drug-resistant epilepsy in children and adults has been reassessed. Although its mechanisms of action have not yet been clarified, their effectiveness in controlling the number and intensity of fits is documented by numerous studies. One of the problems with using ketogenic dietary treatment is the difficulty in following this diet for long periods of time, mainly for reasons linked to its palatability, as this type of approach does not allow for "lapses".

Essential bibliography: Danial NN, Hartman AL, Stafstrom CE, Thio LL. How does the ketogenic diet work? Four potential mechanisms. J Child Neurol. Aug 2013;28(8):1027-1033. Kossoff E. The fat is in the fire: ketogenic diet for refractory status epilepticus. Epilepsy currents / American Epilepsy Society. 2011;11(3):88-89. Levy RG, Cooper PN, Giri P. Ketogenic diet and other dietary treatments for epilepsy. Cochrane database of systematic reviews (Online). 2012;3:CD001903. Paoli A, Bianco A, Damiani E, Bosco G. Ketogenic Diet in Neuromuscular and Neurodegenerative Diseases. Biomed Res Int. 2014;2014:474296. Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. Aug 2013;67(8):789-796. Tagliabue A, Bertoli S, Trentani C, Borrelli P, Veggiotti P. Effects of the ketogenic diet on nutritional status, resting energy expenditure, and substrate oxidation in patients with medically refractory epilepsy: a 6-month prospective observational study. Clinical nutrition (Edinburgh, Scotland). 2012;31(2):246-249.

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