Practical Considerations for Ketogenic Diet in Adults With Super-Refractory Status Epilepticus

Neha Kaul; Joshua Laing; John-Paul Nicolo; Judy Nation; Patrick Kwan; Terence J O'Brien

doi:10.1212/CPJ.0000000000001009

Practical Considerations for Ketogenic Diet in Adults With Super-Refractory Status Epilepticus

Neurol Clin Pract. 2021 Oct;11(5):438-444. doi: 10.1212/CPJ.0000000000001009.

Authors

Neha Kaul¹, Joshua Laing¹, John-Paul Nicolo¹, Judy Nation¹, Patrick Kwan¹, Terence J O'Brien¹

Affiliation

¹ Department of Allied Health (Clinical Nutrition) (NK), Royal Melbourne Hospital; Department of Nutrition and Dietetics, (NK) Alfred Hospital; Departments of Medicine and Neurology (NK, J-PN, JN, PK, TJO), Royal Melbourne Hospital, University of Melbourne; and Departments of Neurosciences and Neurology (NK, JL, J-PN, PK, TJO), Alfred Hospital and Monash University, Melbourne, Australia.

Abstract

Purpose of review: Ketogenic diet therapy can be used as an adjuvant treatment of super-refractory status epilepticus (SRSE). However, the drug and metabolic interactions with concomitant treatments present a challenge for clinicians. In this review, we focus on the practical considerations of implementing ketogenic dietary therapy in the acute setting, including the dietary composition, potential drug-diet interactions, and monitoring during ketogenic treatment.

Recent findings: This report describes the ketogenic diet therapy protocol implemented for the treatment of SRSE and a review of the current evidence to support clinical practice.

Summary: The control of SRSE is critical in reducing morbidity and mortality. There is emerging evidence that ketogenic diet may be a safe and effective treatment option for these patients.

Publication types

Review