Ketogenic diet in pediatric seizures: a randomized controlled trial review and meta-analysis

Expert Rev Neurother. 2022 Feb;22(2):169-177. doi: 10.1080/14737175.2022.2030220. Epub 2022 Feb 25.


Background: The ketogenic diet is a non-pharmacologic treatment option for children with drug-resistant epilepsy. This systematic review and meta-analysis aimed to assess the efficacy of the ketogenic diet on seizures frequency in children.

Methods: We reviewed the literature using Cochrane, EMBASE, MEDLINE, and highly qualified journals.Randomized controlled trials were chosen to investigate the seizures-free regime or at least 50% seizures reduction after three months from the starting of the ketogenic diet or earlier. We have selected articles from January 2011 to January 2020.Eight articles were eligible. The data show a significant reduction in seizure frequency in the dietary treatment pediatric population. The rate of a seizures-free regime or at least 50% seizures reduction was 48.31% of patients in the intervention group.

Results: Our overall meta-analysis underlined the significant efficacy. The KD group is 5.6 times more likely than the control group to have a 50% reduction of seizures after three months of the diet or earlier.QUADAS and AMSTAR assessments showed a low risk of bias and adequate accuracy.

Conclusion: The results show that the KD reduces seizure frequency in children with drug-refractory epilepsy. KD is an effective treatment option for children and adolescents with refractory epilepsy.

Keywords: Children- pediatric- infant-childhood - epilepsy - ketogenic – diet-seizure- treatment.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Child
  • Diet, Ketogenic* / methods
  • Drug Resistant Epilepsy*
  • Humans
  • Randomized Controlled Trials as Topic
  • Seizures
  • Treatment Outcome