Identification of cerebral acetone by 1H-MRS in patients with epilepsy controlled by ketogenic diet

MAGMA. 1999 Mar;8(1):33-42. doi: 10.1007/BF02590633.


Ketogenic diet (KD) is highly effective in controlling epileptic seizures in children. One of the mechanisms postulated, the accumulation of ketone bodies, acetoacetate (AcAc) and/or betahydroxybutyrate (beta-OHB) in the brain, would be detectable by non-invasive proton magnetic resonance spectroscopy (1H-MRS). 1H-MRS was performed in occipital cortical grey matter in 14 epileptics (E); ages 3.8-48.3 years), seven KD and seven without, and 16 healthy age-matched subjects. One E was examined before and after KD. A singlet resonance (sigma = 2.22 ppm), distinct from AcAc (sigma = 2.26 and 3.46 ppm), and identified as acetone was present in all spectra of children on KD (nine spectra in five children; concentration 0.7 +/- 0.2 mM). This resonance was absent from Control and E without diet. AcAc and beta-OHB, which were not detectable in KD brain, were found in urine or blood of all KD. Seizures were well controlled in all E in whom acetone was detected. Two of seven E, both adults, were seizure-free without detectable acetone. Cerebral acetone may contribute to seizure control in KD, but is unlikely to be the sole mechanism.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acetone / metabolism*
  • Adolescent
  • Adult
  • Brain / metabolism*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Dietary Fats / administration & dosage
  • Epilepsy / diet therapy*
  • Epilepsy / metabolism*
  • Female
  • Humans
  • Ketone Bodies / metabolism
  • Magnetic Resonance Spectroscopy / methods*
  • Male
  • Middle Aged


  • Dietary Fats
  • Ketone Bodies
  • Acetone