Dietary treatment of epilepsy: Rebirth of an ancient treatment

Since its introduction in 1921, the ketogenic diet has been incontinuous use for children with difficult-to-control epilepsy.After decades of relative disuse, it is now both extremelypopular and well studied, with approximately two-thirds ofchildren demonstrating significant seizure reduction after 6 months. It is being used for less intractable seizures in childrenas well as recently adults. Modifications that helpimprove tolerability include the medium chain triglyceridediet, modified Atkins diet, and low glycemic index treatment.Major side effects include acidosis, increased cholesterol, kidneystones, gastroesophageal reflux, and growth disturbance.However, these side effects are usually treatable and nowadaysoften even preventable. Future non-epilepsy indicationssuch as Alzheimer disease, amyotrophic lateral sclerosis,autism, and brain tumors are under active investigation. Thisdietary treatment for epilepsy has undergone a rebirth. Itswidespread use in Poland and Europe is a welcome additionaltreatment for those with drug-resistant epilepsy.