Ketogenic diet for infants with epilepsy: A literature review

• Published in: Epilepsy & behavior 2020-11, Vol.112, p.107361-107361, Article 107361
• Main Authors: Falsaperla, Raffaele, D'Angelo, Gabriella, Praticò, Andrea D., Mauceri, Laura, Barbagallo, Massimo, Pavone, Piero, Catanzaro, Stefano, Gitto, Eloisa, Corsello, Giovanni, Ruggieri, Martino
• Format: Article
• Language: English
• Subjects: Diet, Ketogenic - adverse effects; Diet, Ketogenic - methods; Disease Management; Drug Resistant Epilepsy - diet therapy; Drug-resistant epilepsy; Epilepsy; Epilepsy - diet therapy; Female; Glucose Transporter Type 1; Glucose transporter type 1 deficiency; Humans; Infant; Infant, Newborn; Ketogenic diet; Male; Seizures - etiology; Treatment Outcome
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2020.107361

The ketogenic diet (KD) is an established, nonpharmacological treatment for drug-resistant epilepsy (DRE). Actually, KD and its variants have been shown to be elective and resolute for patients with glucose transporter type 1 (GLUT1) deficiency. The aim of this review was to study the use of KD and its variants in infancy, including the neonatal age, and demonstrate the safety and efficacy of this treatment in patients with the age of 0–23 months affected by DRE already subjected to pharmacological approach attempts. A literature search was conducted using PubMed as the medical database source. We used the age limit of 0–23 months, and we considered only articles published between the years 2015 and 2018, in light of increasing interest worldwide in the use of KD and its variants to manage DRE. We included 52 publications: 1 Cochrane study, 22 retrospective studies, 9 prospective studies, 4 randomized controlled trials (RCTs), 12 clinical cases, and 4 clinical reviews. Literature data showed that KD and its variants are safe and useful in patients with the age of 0–23 months with DRE. Classical KD is of first choice in the treatment of GLUT1 deficiency. Earlier introduction of KD in GLUT1 promises a better outcome and a decrease in seizure frequency in these patients. •The ketogenic diet is safe and useful in pediatric non-pharmacological treatment for drug-resistant epilepsy.•KD is of first choice in the treatment of Glucose transporter type 1 disorder and Pyruvate Dehydrogenase Complex deficiency.•KD in neonates with drug-resistant epilepsy is useful to perform a prompt diagnosis of Glucose transporter type 1 deficiency.