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Introduction/Summary.
{{Skeleton}}
=History=
* Medieval history
* Displacement with drug therapy
* Resurgence and the Charlie foundation
=Evolution of the [[Ketogenic Diet]] for Epilepsy=
* Calorie restriction no longer used
* New diets – [[MCT Diet]], [[Modified Atkins Diet]] MAD
* Wider usage
=General =
* The experts suggest that if the [[Ketogenic Diet]] is going to help with childhood seizures, it will do so within 3 months.
* It is unclear if the [[Ketogenic Diet]] is safe for pregnancy in the general population, but it is probably much safer than anticonvulsant drugs that have known birth defect risks
* Taking a large drink can cause some (but not all) children to experience 'breakthrough seizures'<ref name="Kossoff-2011-2220"/>.
=Initiation and Fasting=
* Value of fasting
* Hospitalization requirements
* After the fasting period, the calorie intake is typically increased in a stepwise fashion; 1/3<sup>rd</sup> the first day, 2/3<sup>rd</sup> the second day, then the full allotment from then on<ref name="Kossoff-2011-2469"/>.
=Success rate for Epilepsy=
So far the ketogenic diet has only been used on children who have not responded to multiple medications, so the success rate could be quite different if it were applied sooner. Also 'success' can be subjective; for some only a total prevention of all seizures would constitute success, whereas others might consider a reduction in the seizure frequency successful. Generally with the ketogenic diet around of 50% of patients have a 50% reduction in seizures, 25% have 90% reduction in seizures, and around 10% become seizure free. The success rate also varies with the type of epilepsy – please read chapter 5 ("Is my child a good candidate for the Ketogenic Diet") of "Ketogenic Diets: treatments for epilepsy and other disorders" by Eric Kossoff for more details. In adults, weight loss is correlated with better response, though this could be due to the weight loss indicating better compliance with the diet<ref name="Kossoff-2011-4020"/>.
* 50% of patients have a 50% reduction in seizures
* 25% have 90% reduction in seizures
** chapter 5 ("Is my child a good candidate for the [[Ketogenic Diet]]") of "[http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic Diets: treatments for epilepsy and other disorders]" by Eric Kossoff for more details.
* In adults, weight loss is correlated with better response, though this could be due to the weight loss indicating better compliance with the diet.
=Types of Ketogenic Diets for Epilepsy=
There are several types of [[Ketogenic Diet]] used for epilepsy treatment:
* [[Ketogenic Ratio Diet]]. This diet has a strict controls over calorie intake and the ketogenic ratio, which is typically between 3:1 and 4:1. The diet is normally started with a hospital stay and includes a short fast.
* [[MCT Diet]]. This is a variant of the traditional diet that uses MCT oil that produces more ketones than other oils.
* [[Modified Adkins Atkins Diet]] (MAD). The MAD started by accident, when a child was put onto the Adkins Atkins diet prior to starting the traditional [[Ketogenic Diet]] and their seizures stopped.
* [[Low Glycemic Index Treatment]] (LGIT). The LGIT restricts the carbohydrate intake to only those foods with a [[Glycemic Index]] of less than 50. However, the LGIT is more than just restricting the glycemic index, and requires a fat intake of 60% with a ketogenic ratio of 1:1. The LGIT is similar to the MAD and restricts carbohydrates to 40-60 grams/day.
=General=
The experts suggest that if the ketogenic diet is going to help with childhood seizures, it will do so within 3 months<ref name="Kossoff-2011-1946"/>.
The ketogenic diet has traditionally been fine tuned to maintain urine ketone levels to 3-4+ (80-160 mmol<ref name="Kossoff-2011-2030"/>.
Studies have shown a correlation between >90% seizure control and lower blood glucose levels<ref name="Kossoff-2011-3260"/>.
It is unclear if the ketogenic diet is safe for pregnancy in the general population, but it is probably much safer than anticonvulsant drugs that have known birth defect risks<ref name="Kossoff-2011-4040"/>
{{KetoSeeAlso}}
=References=
<references>
<ref name="Kossoff-2011-4040">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 4040</ref>
<ref name="Kossoff-2011-3260">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 3260</ref>
<ref name="Kossoff-2011-2030">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2030</ref>
<ref name="Kossoff-2011-1946">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 1946</ref>
<ref name="Kossoff-2011-4020">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 4020</ref>
<ref name="Kossoff-2011-2469">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2469</ref>
<ref name="Kossoff-2011-2220">Eric. Kossoff, [http://www.amazon.com/Ketogenic-Diets-Eric-H-Kossoff/dp/1936303108 Ketogenic diets : treatments for epilepsy and other disorders], date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2220</ref>
</references>
