Chapter

Mechanisms of Ketogenic Diet Action

Susan A. Masino and Jong M. Rho

in Jasper's Basic Mechanisms of the Epilepsies

Fourth edition

Published on behalf of ©Jeffrey L. Noebels, Massimo Avoli, Michael A. Rogawski, Richard W. Olsen, and Antonio V. Delgado-Escueta

Published in print July 2012 | ISBN: 9780199746545
Published online April 2013 | e-ISBN: 9780199322817 | DOI: http://dx.doi.org/10.1093/med/9780199746545.003.0078

Series: Contemporary Neurology Series

Mechanisms of Ketogenic Diet Action

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The evidence for a KD as a successful epilepsy treatment is clear. Multiple retrospective, multi-center, and randomized prospective studies document consistent and significant clinical benefits. The true efficacy of dietary treatments for epilepsy may be underestimated, as the KD is rarely used as a first-line therapy. Certainly, by the time the KD is initiated to thwart medically refractory epilepsy, in some instances the severity of the epileptic condition may be too difficult to overcome. But remarkably, the KD works in the majority of patients who failed to respond to numerous antiepileptic drugs. A detailed understanding of key KD mechanisms could offer a meaningful adjuvant or ultimately the development of a “diet in a pill.”3 But while clinical applications of metabolism-based therapy appear to be growing rapidly, there is a continuing need to develop modified diet formulations with improved efficacy and tolerability (as well as palatability) and to identify new pharmacological targets for drug discovery.

Chapter.  14373 words.  Illustrated.

Subjects: Neurology

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