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Ketogenic Diet

The ketogenic diet is a strict, mathematically calculated diet high in fat and low in protein and carbohydrates that, when followed conscientiously, produces a by-product called ketones in patients' blood and urine. The diet is supplemented with vitamins and calcium, so patients do not suffer from any nutritional imbalance.


When carefully monitored by a medical team familiar with its use, the diet helps two out of three children who are tried on it and may prevent seizures completely in one out of three.
According to
Several studies have shown that the ketogenic diet does reduce or prevent seizures in many children whose seizures could not be controlled by medications. Over half of children who go on the diet have at least a 50% reduction in the number of their seizures. Some children, about 1 in 10, even become seizure-free.

Potential Adverse Events

According to a study published in Epilepsia 2004;45:11161123 (Early- and Late-Onset Complications of the Ketogenic Diet for Intractable Epilepsy):
The most common early-onset complication was dehydration, especially in patients who started the KD with initial fasting. Gastrointestinal disturbances, such as nausea/vomiting, diarrhea, and constipation, also were frequently noted, sometimes associated with gastritis and fat intolerance. Other early-onset complications, in order of frequency, were hypertriglyceridemia, transient hyperuricemia, hypercholesterolemia, various infectious diseases, symptomatic hypoglycemia, hypoproteinemia, hypomagnesemia, repetitive hyponatremia, low concentrations of high-density lipoprotein, lipoid pneumonia due to aspiration, hepatitis, acute pancreatitis, and persistent metabolic acidosis. Late-onset complications also included osteopenia, renal stones, cardiomyopathy, secondary hypocarnitinemia, and iron-deficiency anemia. Most early- and late-onset complications were transient and successfully managed by careful follow-up and conservative strategies. However, 22 (17.1%) patients ceased the KD because of various kinds of serious complications, and 4 (3.1%) patients died during the KD, two of sepsis, one of cardiomyopathy, and one of lipoid pneumonia.


The ketogenic diet requires medical supervision and regular testing to ensure compliance with the diet and to prevent or mitigate any adverse effects. The diet requires vitamin supplementation and possibly specialty food products. For the scoring on the chart, it is assumed that much of these costs will be out of pocket expenses. If your insurance program offers significant coverage, you could revise the score upwards when considering the chart.


This is a diet that needs to be adopted as a permanent lifestyle change. It requires continuous active participation to maintain seizure control.


Seizure control could start occurring within days to weeks of starting the diet. In studies, the seizure control continues to improve over several months.

Special Notes

You can find peer support for the Ketogenic diet at Matthew's Friends, a registered non-profit group of parents with children using the Ketogenic diet.

Return to the chart of alternative epilepsy treatments.

This page last modified September 26, 2011.

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