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Dietary Treatment of Intractable Epilepsy

Cervenka, Mackenzie C. MD; Kossoff, Eric H. MD

CONTINUUM: Lifelong Learning in Neurology: June 2013 - Volume 19 - Issue 3, Epilepsy - p 756–766
doi: 10.1212/01.CON.0000431396.23852.56
Review Articles

Purpose of Review: Dietary therapies for seizure management date back further than pharmacologic interventions, but many neurologists are not familiar with these treatment options. This introduction to dietary therapies will discuss administration of ketogenic diets, comparisons between diet types, evidence-based efficacy of diet therapies in epilepsy treatment, and management of side effects. This review will provide the general neurologist with the skills to identify appropriate candidates for these treatments and to offer comprehensive ongoing care.

Recent Findings: In adults and children with medically resistant epilepsy, studies have consistently shown a greater than 50% reduction in seizure frequency in approximately one-half of patients within days to months after starting dietary therapy.

Summary: Dietary treatment options for epilepsy include the classic ketogenic diet, the medium-chain triglyceride diet, the modified Atkins diet, and the low glycemic index treatment. These were first used to control seizures in children with intractable epilepsy, but in recent years have also been demonstrated to be safe and effective in children and adults with a broad range of seizure types and are being used with increased frequency worldwide.

Address correspondence to Dr Mackenzie C. Cervenka, Department of Neurology, Epilepsy Center, Johns Hopkins University School of Medicine, 600 North Wolfe St, Meyer 2-147, Baltimore, MD 21287,

Relationship Disclosure: Dr Cervenka receives a grant from Nutricia. Dr Kossoff has served as a consultant for Atkins Nutritionals, Eisai Co, Ltd, and Nutricia, and receives research support from Nutricia.

Unlabeled Use of Products/Investigational Use Disclosure: Drs Cervenka and Kossoff report no disclosures.

© 2013 American Academy of Neurology
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