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Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients
Published on: December 18, 2016
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Ketogenic diets for drug-resistant epilepsy.
Kirsty J Martin-McGill1, Cerian F Jackson, Rebecca Bresnahan
1Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Lower Lane, Liverpool, UK, L9 7LJ.
The Cochrane Database of Systematic Reviews
|November 8, 2018
Summary
Ketogenic diets (KDs) show promise for reducing seizures in drug-resistant epilepsy, particularly in children. However, evidence quality is low to very low, with significant adverse effects and high dropout rates noted.
Area of Science:
- Neurology
- Dietary Interventions
- Epilepsy Management
Background:
- Ketogenic diets (KDs), high-fat, low-carbohydrate diets, are explored for epilepsy management.
- Currently recommended for drug-resistant epilepsy in children, with growing interest in modified versions (MAD) for adults.
- This review updates evidence on KD efficacy and safety for drug-resistant epilepsy.
Purpose of the Study:
- To assess the effectiveness of ketogenic diets (KDs) in managing drug-resistant epilepsy.
- To review evidence from randomized controlled trials (RCTs) on KD use in epilepsy.
Main Methods:
- Searched multiple databases (Cochrane, MEDLINE, ClinicalTrials.gov) up to April 2017 for RCTs.
- Included randomized or quasi-randomized controlled trials of KDs for drug-resistant epilepsy.
- Two independent reviewers extracted data and assessed study quality; meta-analysis was not possible due to heterogeneity.
Main Results:
- Eleven RCTs (778 participants, mostly children) were included; evidence quality was low to very low.
- Classical 4:1 KD showed seizure freedom rates up to 55% and reduction up to 85% in children.
- Modified Atkins Diet (MAD) showed seizure freedom up to 25% and reduction up to 60% in children; adverse effects were common across all diets.
Conclusions:
- RCTs suggest KDs are promising for epilepsy, but limited studies (especially in adults) and low evidence quality necessitate caution.
- Adverse effects (e.g., gastrointestinal issues) and poor adherence were significant challenges, leading to high dropout rates.
- While KDs remain a valid option for intractable epilepsy, further research, particularly on long-term effects and adult populations, is crucial.
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