Open AccessKetogenic diet for treatment of intractable epilepsy in adults: A meta‐analysis of observational studies
Author(s) -
Liu Hongyan,
Yang Yi,
Wang Yunbing,
Tang Hong,
Zhang Fan,
Zhang Yong,
Zhao Yong
Publication year - 2018
Publication title -
epilepsia open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.247
H-Index - 16
ISSN - 2470-9239
DOI - 10.1002/epi4.12098
Subject(s) - ketogenic diet , epilepsy , meta analysis , medicine , observational study , adverse effect , cochrane library , weight loss , drug resistant epilepsy , intractable epilepsy , pediatrics , glycemic , insulin , psychiatry , obesity
Summary The ketogenic diet ( KD ) is an effective treatment for children with drug‐resistant epilepsy and has been widely used in young children. Adult patients with intractable epilepsy would also benefit from this dietary treatment. However, only a few studies have been published, and the use of the KD in intractable epilepsy in adults has been limited. This meta‐analysis summarized the findings of the relevant published studies to identify the efficacy of the KD for the treatment of intractable epilepsy in adults. In this meta‐analysis, PubMed, Embase, and Cochrane Library were used for searching studies concerning the effects of the KD and its major subtypes with intractable epilepsy in adults published up to January 10, 2017. The primary outcomes were seizure freedom, seizure reduction by 50% or more, and seizure reduction by <50%. The quality of the methodology of the observational studies was reviewed by using the Newcastle‐Ottawa Scale. We identified 402 articles, of which, 16 studies including 338 patients met the inclusion criteria. The results of the meta‐analysis showed that the combined efficacy rates of all the symptoms of seizure freedom, seizure reduction by 50% or more, and seizure reduction below 50% in adults with intractable epilepsy were 13%, 53%, and 27%, respectively. The adverse reactions of the KD were mild, whereas low glycemic index diet ( LGID ) and low‐dose fish oil diet ( LFOD ) may have fewer side effects. Weight loss, high level of low‐density lipoprotein, and elevated total cholesterol were most frequent. The meta‐analysis indicates that the KD for refractory epilepsy in adults is a well‐tolerated treatment and that its side effects are acceptable, which show that the KD is a promising treatment in adult intractable epilepsy. Further research is needed to assess which type of diet or ratio is more effective in the KD treatment.