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Semin Neurol 2025; 45(02): 221-231
DOI: 10.1055/a-2534-3335
Review Article

Dietary Therapies in Epilepsy

Shilpa B. Reddy 
1   Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Nashville, Tennessee
,
Emma G. Carter
1   Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Nashville, Tennessee
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Abstract

Ketogenic diet therapies are an increasingly utilized treatment option for adult and pediatric patients with drug-resistant epilepsy. The two most common are the classic ketogenic diet, following a ratio of fat to combined protein and carbohydrates (typically 4:1), and the modified Atkins diet, limiting total carbohydrates to 10 to 30 g per day. Based on high-quality studies in pediatric patients, the classic ketogenic and modified Atkins diets show >50% reduction in seizure frequency in approximately 40 to 50% of patients. Although there are fewer overall and high-quality studies in adults, they show similar seizure efficacy rates, but notably high rates of noncompliance. In addition to improved seizure outcomes, ketogenic diet therapies have been associated with improved cognitive and quality of life measures. Ketogenic diet therapies are generally safe but require monitoring to ensure adequate growth and tolerance. The core of a ketogenic diet program is a well-trained multidisciplinary team, supported by operational and evidence-based protocols.

Keywords

ketogenic diet - modified Atkins diet - drug-resistant epilepsy - diet therapy


Publication History

Accepted Manuscript online:
06 February 2025

Article published online:
25 February 2025

© 2025. Thieme. All rights reserved.

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