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Epilepsia. 2009 Feb;50(2):322-5. doi: 10.1111/j.1528-1167.2008.01740.x. Epub 2008 Aug 19.

A blinded, crossover study of the efficacy of the ketogenic diet.

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  • 1Departments of Neurology and Pediatrics, The John M Freeman Pediatric Epilepsy Center, Baltimore, Maryland, USA.


Despite over 80 years of use, the ketogenic diet (KD) has never been tested in a blinded manner. Twenty children with intractable Lennox-Gastaut syndrome (LGS) were fasted 36 h and then randomized to receive the classic KD in conjunction with a solution containing either 60 g/day of glucose or saccharin. Parents and physicians were blinded to both the solution composition and level of ketosis. A crossover to the KD with the alternate solution occurred following the sixth day and a repeat fast. A 24-h electroencephalography (EEG) was obtained at baseline and after each arm. After administration of the solution, there was moderate evidence of a reduction in parent-reported seizures between the glucose and saccharin arms, with a median difference of 1.5 seizures per day (p = 0.07). There was no reduction in the number of EEG-identified events, with a median reduction of 7 events per day (p = 0.33). Ketosis was not completely eliminated in the glucose-added arm.

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