Dietary therapy of epilepsy in the nineties; renewed experience with the ketogenic diet
1998
Prasad, A.N. | Stafstrom, C.E.
From a serendipitous observation that fasting temporarily suppresses epileptic seizures, arose the idea that a diet would mimic the metabolic effects of ketosis. The so named "ketogenic diet" has enjoyed a renewal of interest amongst physicians and the public in recent years, partly because of dramatic proclamation by the media that a miracle cure has been long ignored by the medical establishment. The efficacy of the ketogenic diet until recently has not been rigorously examined through scientific trials. We examine the historical precedent to the use of the ketogenic diet as treatment for epileptic seizures, and critically review previous and current research regarding its efficacy and mechanisms of action. Despite the efficacy of the diet in a wide variety of difficult to treat epileptic seizures in children and adults, there remain several limitations. Although a metabolic adaptation within the brain is thought to be responsible for its action, the precise mechanisms at a cellular level remain poorly understood. Further research on the ketogenic diet needs to focus on precisely defining indications, mechanisms of action, safety and impact on quality of life in epilepsy.
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