Ketogenic Diets: An Update for Child Neurologists

@article{Kossoff2009KetogenicDA,
  title={Ketogenic Diets: An Update for Child Neurologists},
  author={Eric H. Kossoff and Beth A Zupec-Kania and Jong M. Rho},
  journal={Journal of Child Neurology},
  year={2009},
  volume={24},
  pages={979 - 988}
}
The ketogenic diet, modified Atkins diet, and low-glycemic-index treatment have all emerged over the past decade as important therapeutic options for children with intractable epilepsy. Whereas only a decade ago the ketogenic diet was seen as an ``alternative'' treatment of last resort, it has become more frequently used throughout the world. The past year alone 2 randomized and controlled trials of the ketogenic diet were published, as well as the use of the ketogenic diet for new-onset… 

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References

SHOWING 1-10 OF 93 REFERENCES
The ketogenic diet: Uses in epilepsy and other neurologic illnesses
TLDR
A growing body of literature suggests the ketogenic diet may be beneficial in certain neurodegenerative diseases, including Alzheimer disease, Parkinson’s disease, and amyotrophic lateral sclerosis, in which it appears to be neuroprotective.
KETOGENIC DIETS IN THE TREATMENT OF EPILEPSY: SHORT‐TERM CLINICAL EFFECTS
TLDR
The three ketogenic diets were shown to be effective in the short‐term management of children whose epilepsy is poorly controlled with anticonvulsant drugs.
Biochemical Abnormalities of the Ketogenic Diet in Children
TLDR
Evaluated the children at the institution utilizing the ketogenic diet not only for the complications of stone formation but also for other biochemical abnormalities.
Efficacy of the Atkins diet as therapy for intractable epilepsy
TLDR
Preliminary evidence that the Atkins diet may have a role as therapy for patients with medically resistant epilepsy is provided.
Long‐term management of the ketogenic diet: Seizure monitoring, nutrition, and supplementation
TLDR
The ketogenic diet is a medical nutrition therapy for the treatment of epilepsy which includes a diet history, assessment, diet therapy and a follow‐up plan of care established by the American Dietetic Association.
Benefits of an All‐Liquid Ketogenic Diet
TLDR
It is found that 61 children started on the ketogenic diet at the authors' institution had better seizure control than that described for the typical solid food–fed child, with 59% having >90% control at 12 months, compared with 27% in a larger cohort (4).
Efficacy of the Ketogenic Diet as a Treatment Option for Epilepsy: Meta-analysis
TLDR
The results indicate that children with generalized seizures and patients who respond with > 50% seizure reduction within 3 months tend to remain on the diet longer, and current observational studies reporting on the therapeutic effect of the ketogenic diet contain valuable statistical data.
Management and Risk Factors for Dyslipidemia With the Ketogenic Diet
TLDR
Children receiving a solely formula-based ketogenic diet were less likely to have hypercholesterolemia than those eating solid food after adjusting for age and initial ketogenic ratio, and interventions for dyslipidemia were analyzed for their effectiveness.
Ketogenic diet for epilepsy.
  • R. Levy, P. Cooper
  • Medicine, Psychology
    The Cochrane database of systematic reviews
  • 2003
TLDR
There is no reliable evidence from randomized controlled trials to support the use of ketogenic diets for people with epilepsy, and the ketogenic diet is considered a possible option for those with a difficult epilepsy on multiple antiepileptic drugs.
The ketogenic diet and epilepsy
TLDR
There is growing evidence that the ketogenic diet alters the fundamental biochemistry of neurons in a manner that not only inhibits neuronal hyperexcitability but also induces a protective effect, which may ultimately be useful in the treatment of a variety of neurological disorders.
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