Acta Scientific Pharmaceutical Sciences (ISSN: 2581-883X)

Review Article Volume 4 Issue 8

Ketogenic Diet as a Non-pharmacological Treatment in Epileptic Disorders in a Tertiary Hospital

Margarita Castro Rey1*, Alejandra Melero González2, Selma Vázquez Martín2, Carmen Alonso Vicente3, Sara González Uribelarrea1, José Manuel Marugán de Miguelsanz3 and Patricia Ramos4

1Department of Pediatric, Hospital Clínico Universitario de Valladolid, Spain
2Department of Pediatric Neurology, Hospital Clínico Universitario de Valladolid, Spain
3Department of Pediatric Gastroenterology, Hospital Clínico Universitario de Valladolid, Spain
4Department of Nutritionist, Hospital Clínico Universitario de Valladolid, Spain

*Corresponding Author: Margarita Castro Rey, Department of Pediatric, Hospital Clínico Universitario de Valladolid, Spain.

Received: April 25, 2020; Published: September 18, 2020



Ketogenic diet is a low-carbohydrate, high-fat diet used in children as a non-pharmacological treatment in different diseases (especially in drug-resistant epilepsies and congenital metabolic disorders). Our first objective was to describe the characteristics of the patients treated with ketogenic diet in a tertiary hospital, in addition to reflecting the results and its complications in a short, medium and long term.
We designed a retrospective and descriptive study, collecting children between 0 and 14 years old, who started ketogenic diet after January 2017 in our centre (at that date we designed a following-up protocol).
9 children were included. All of them (100%) had epileptic disorders and had previously been treated with more than two antiepileptic drugs. All patients (100%) were evaluated by a multidisciplinary team (a pediatric neurologist, a pediatric gastroenterologist and a nutritionist) in a first visit. The kind of ketogenic diet and the method of beginning were chosen depending on individual and family characteristics. The most commonly used diet was the standard ketogenic diet (77,7%). 66,7% of patients started the diet at home, without complications.
Out of all side effects registered, the asymptomatic or mild hypoglycaemia was the most frequently observed (100%); followed by gastrointestinal symptoms (88.9%) and micronutrient deficiencies (77,78%).
Three patients (33,3%) decided to leave the study before concluding. The main reason was the high weight loss in two of them and the lack of improvement at 12 months follow up in the other case.
As a result of the above, it was found that the majority of the children treated with ketogenic diet controlled their seizures (88,89%), with good results in cognitive statements (44,4%) and quality of life (44,4%).
In conclusion it can be concluded that ketogenic diet seems to have been an effective instrument to control seizures and to produce a cognitive and functional improvement in children with drug-resistant epileptic disorders. In general, the diet has been well tolerated with a good treatment adherence. Side effects registered are in accordance with those described in other manuscripts, being the most of them slight effects. Serious complications were not registered.

Keywords: Ketogenic Diet; Epilepsy; Feeding; Seizures



  1. Lee PR and Kossoff KE. “Dietary treatments for the epilepsy: management guidelines for the general practitioner”. Epilepsy Behavior2 (2011): 115-121.
  2. Wheless JW. “History and origin of the ketogenic diet”. En: Stafstrom CE, Rho JM, editors. Epilepsy and ketogenic diet. Totowa NJ: Humana Press (2004): 31-50.
  3. Guelpa G and Marie A. “La lutte contre l’épilepsie par la désintoxication et par la rééducation alimentaire”. Rev Ther Medico-Chirurgicale 78 (1911): 8-13.
  4. Freeman JM., et al. “The epilepsy diet treatment: an introduction to the ketogenic diets”. 2 ed. New York: Demos (1996).
  5. Titre-Johnson S., et al. “Ketogenic diet in the treatment of epilepsy in children under the age of 2 years: study protocol for a randomised controlled trial”. Trials 18 (2017): 195
  6. Maalouf M., et al. “The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies”. Brain Research Reviews 59 (2009): 293-315.
  7. Bough KJ and Rho JM. “Anticonvulsant mechanisms of the ketogenic diet”. Epilepsia 48 (2007): 43-58.
  8. Carballo R., et al. “Long-term follow-up of the ketogenic diet for refractory epilepsy: multicentre Argentinean experience in 216 pediatric patients”. Seizure 20 (2011): 640-645.
  9. Pearson TS., et al. “Phenotypic spectrum of glucose transporter type 1 deficiency syndrome (Glut1 DS)”. Current Neurology and Neuroscience Reports 4 (2013): 342.
  10. García-Peñas JJ. “Trastornos del espectro autista y epilepsia: el papel de la dieta cetogénica”. Revista de Neurología 62 (2016): S73-78.
  11. Kim JA., et al. “Efficacy of the classic ketogenic and the modified Atkins diets in refractory childhood epilepsy”. Epilepsia 1 (2016): 51-58.
  12. Cross JH., et al. “The ketogenic diet in childhood epilepsy: where are we know?” Archives of Disease in Childhood 95 (2010): 550-553.
  13. Armeno M., et al. “Consenso nacional sobre dieta cetogénica”. Revista de Neurología5 (2014): 213-223.
  14. Bergqvist AG., et al. “Fasting versus gradual initiation of the ketogenic diet: a prospective, randomized clinical trial of efficacy”. Epilepsia11 (2005): 1810-1819.
  15. Ballaban-Gil K., et al. “. Complications of the ketogenic diet”. Epilepsia7 (1998): 744-748.
  16. García-Peñas JJ. “Epilepsia, cognición y dieta cetogénica”. Revista de Neurología 66 (2018): S71-S75.


Citation: Margarita Castro Rey., et al. “Ketogenic Diet as a Non-pharmacological Treatment in Epileptic Disorders in a Tertiary Hospital".Acta Scientific Pharmaceutical Sciences 4.10 (2020): 31-36.


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