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Epilepsia. 2015 Sep;56(9):1330-4. doi: 10.1111/epi.13074. Epub 2015 Jul 22.

Dietary therapy is not the best option for refractory nonsurgical epilepsy.

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Hospital Italiano Buenos Aires, Buenos Aires, Argentina.


The ketogenic diet (KD) is currently a well-established treatment for patients with medically refractory, nonsurgical epilepsy. However, despite its efficacy, the KD is highly restrictive and constitutes a treatment with serious potential adverse effects, and often with difficulties in its implementation and compliance. Patients on the KD require strict follow-up and constant supervision by a medical team highly experienced in its management in order to prevent complications. Other alternative treatments for patients with refractory epilepsy include vagus nerve stimulation (VNS), new-generation antiepileptic drugs (AEDs), corpus callosotomy (CC), and responsive focal cortical stimulation (RNS). In this review, we explain not only the difficulties of the KD as a therapeutic option for refractory epilepsy but also the benefits of other therapeutic strategies, which, in many cases, have proven to have better efficacy than the KD itself.


Corpus callosotomy; Epilepsy; Ketogenic diet; New-generation antiepileptic drugs; Vagus nerve stimulation

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