The ketogenic diet as a treatment option in adults with chronic refractory epilepsy: efficacy and tolerability in clinical practice

Epilepsy Behav. 2012 Mar;23(3):310-4. doi: 10.1016/j.yebeh.2012.01.002. Epub 2012 Feb 25.


The ketogenic diet (KD) is a high-fat, low-protein, low-carbohydrate diet that is used as a treatment for patients with difficult-to-control epilepsy. The present study assesses the efficacy and tolerability of the KD as an add-on therapy in adults with chronic refractory epilepsy. 15 adults were treated with the classical diet or MCT diet. During a follow-up period of 1 year we assessed seizure frequency, seizure severity, tolerability, cognitive performance, mood and quality of life (QOL). We found a significant reduction in seizures among the patients who followed the diet at least 1 year (n=5). Of these 5 patients, 2 had a reduction between 50 and 90%. Analyzing the study months separately, we found a seizure reduction of ≥50% in 26.6% of the patients during at least 1 month of treatment. Common side-effects were gastrointestinal disorders, loss of weight and fatigue. There was a considerable, non-significant improvement found in mood and QOL scores. Improvements were independent of reduction in seizure frequency, indicating that the effects of the KD reach further than seizure control.

MeSH terms

  • Adolescent
  • Adult
  • Anticonvulsants / therapeutic use
  • Chronic Disease
  • Diet, Ketogenic / adverse effects
  • Diet, Ketogenic / methods*
  • Emotions / physiology
  • Epilepsy / diet therapy*
  • Epilepsy / psychology
  • Female
  • Follow-Up Studies
  • Gastrointestinal Diseases / etiology
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Psychological Tests
  • Quality of Life
  • Treatment Outcome
  • Young Adult


  • Anticonvulsants