Can the ketogenic diet help in the treatment of childhood epileptic encephalopathies? A literature review

Epileptic encephalopathies are entities where epileptic activity is so intense that it contributes to cognitive and behavioral impairment. There are several syndromes that fall into this category such as: West syndrome, Ohtahara syndrome, Dravet syndrome, Doose syndrome and Landau-Kleffner syndrome. Objective: presentation of the clinical indications of the ketogenic diet (CD) as a therapeutic measure in childhood refractory epilepsies, demonstrating the efficacy and side effects expected from this practice. Methodology: a narrative review of the scientific literature (PUBMED and SCIELO) was carried out, with a selection of articles published in the last ten years, also considering renowned magazines and newspapers in the areas of Clinical Neurology, Neuropediatrics and epilepsy. Results: A randomized and controlled clinical trial, conducted in children aged 2 to 16 years with refractory epilepsy, demonstrated that after 3 months, 38% of patients using CD had more than 50% reduction in seizures, compared with four ( 6%) of the control group (p <00001). Corroborating this finding, a Brazilian study demonstrated that 60% of patients with refractory epilepsy and using CD had more than 50% reduction in seizure frequency and 10% were seizure-free. Conclusions: The use of the ketogenic diet demonstrated a favorable result in children with epilepsy refractory to drug treatment. In cases of deficiency in the type 1 glucose transporter and deficiency of pyruvate dehydrogenase, CD should be the treatment of first choice. In cases such as Dravet’s Syndrome, West’s Syndrome, Ohtahara’s Syndrome, Lennox- Gastaut Syndrome and DC Dose Syndrome is part of the therapeutic arsenal.