Ketogenic diet for treatment of drug-resistant epilepsy in children: literature review

Milda Vabalaitė1, Ieva Šmitaitė1

1Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine


Epilepsy is one of the most common neurological disorders affecting 0,5 – 1% of the population. Nowadays there are different medications to treat epilepsy, however, we still face a problem with drug–resistance in all age groups. Therefore, scientists are still researching other ways of reducing the frequency of seizures. The aim of this review is to analyse literature about drug–resistant childhood epilepsy and the effectiveness of ketogenic diet, its side effects and mechanism of action. We analyzed medical publications using international databases like PubMed, Wiley Online Library, ScienceDirect. Keywords and their combinations were: ketogenic diet, children epilepsy, drug–resistant epilepsy, tolerability. Ketogenic diet is safe and effective, however, it requires some extra effort to plan meals and to maintain the diet. This can cause a lot of burden on children and their parents or guardians. Often, the diet is discontinued because of this reason, even though it was effective. The most common side effects are gastrointestinal disorders, less frequent are hyperlipidemia, hyperuricemia, lethargy and others. There has been some negative growth impacts noted in children on ketogenic diet, so it is advisable to monitor their growth. There are many countries that apply this diet as a main or as an additional treatment for drug–resistant epilepsy. Some of these countries are United States, Australia and Europe. It‘s still not known what‘s the mechanism of action of ketogenic diet, although research suggests the importance of ketosis, changes in gut microbiome, different energy sources and anti–inflammatory effects.

Keywords: children epilepsy, drug–resistant epilepsy, ketogenic diet.