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Ketogenic diet for epilepsy

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SBU Assessment

Presents a comprehensive, systematic assessment of available scientific evidence for effects on health, social welfare or disability. Full assessments include economic, social and ethical impact analyses. Assessment teams include professional practitioners and academics. Before publication the report is reviewed by external experts, and scientific conclusions approved by the SBU Board of Directors.

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Published: Revised: 1/2/2002

Findings by SBU Alert

This is a translation of version 1, published on May 18, 1998. The latest version of this report is not available in English.

The ketogenic diet has been used for intractable epilepsy in children, and is a method that has been used sporadically for years. However, only recently has the ketogenic diet been used more systematically in Sweden. Although the treatment has been available for many years, there is little evidence about active mechanisms of diet. Several uncontrolled studies show markedly good effects in terms of seizure reduction. Known, and perhaps yet unidentified, side effects should be weighed against opportunities for improvement in a group of patients with intractable disease. Since the method requires special competence and experience, and since it is very demanding on the families, until further notice it should be used only within the framework of research projects that include systematic followup.

According to the judgment of the SBU Alert, there is currently poor* evidence about the benefits of the method for patients. Hence, it is essential to continue assessing the medical effects, side effects, and costs.

*This assessment by SBU Alert uses a 4-point scale to grade the quality and evidence of the scientific documentation. The grades indicate: (1) good, (2) moderate, (3) poor, or (4) no scientific evidence on the subject.

This summary is based on a report prepared at SBU in collaboration with Per Åmark, MD PhD, The Karolinska Hospital.

Alert is a joint effort by the Swedish Council on Technology Assessment in Health Care (SBU), the Medical Products Agency, the National Board of Health and Welfare, and the Federation of Swedish County Councils.

References

  1. Freeman J M, Vining E P G, Pillas D J, Pyzik P L, Casey J C, Kelly M T. The Ketogenic Diet: A Prospective, Intention-to-treat Evaluation of Efficacy in 150 Children,1998, submitted.
  2. Kinsman S L, Vining E P G, Quaskey S A, Mellits D, Freeman J M. Efficacy of the Ketogenic Diet for Intractable Seizure Disorders: a Review of 58 Cases. Epilepsia 1992;33(6):1132-6.
  3. Swink D, Vining E P, Freeman J M. The Ketogenic Diet: 1997. Advances in Pediatrics 1997;44:297-329.
  4. Vining EP, Freeman JM. For the Multicenter Study of the Efficacy of Ketogenic Diet. Annals of Neurology (abstract) 1996;40:300 A.
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