Although epilepsy has been a well-known neurological disorder for thousands of years, many people with epilepsy today are still unable to achieve complete seizure freedom. After the addition of benzodiazepines to other anticonvulsants in the 1950s, doctors have largely focused on treating epilepsy with medications. Recently an older treatment regimen has been reintroduced into the medical community to help mitigate seizure activity: altering diet. Interestingly, a high fat, low carbohydrate diet regimen called the ketogenic diet has proven to be helpful to some people with refractory epilepsy, that is, epilepsy that does not respond well to medications. In some cases, individuals with epilepsy who have failed over three attempts to control their seizures with medication have complete seizure freedom after maintaining ketosis.
While the exact mechanism of the ketogenic diet treatment is unknown, many have their speculations. The diet is directly related to the diversity and quantity of gut microbiota, and is indirectly related to many other biochemical structures and processes like mitochondrial efficacy and DNA methylation. The mechanism of action for the ketogenic diet in the treatment of epilepsy may be one of or a combination of these biochemical mechanisms.
To fully understand and assess the efficacy of the ketogenic diet and the current research on this topic, I am conducting a meta-analysis of case reports and clinical studies of the ketogenic diet in epilepsy. My goal is to determine the most beneficial uses of the ketogenic diet within different subgroups of epilepsy such as Dravet Syndrome. I also hope to assess the diet’s efficacy as a primary treatment instead of its current use as a secondary treatment that takes place after many medication failures.