title: [A ketogenic diet: is this a valid alternative in refractory epilepsy].
abstract: BACKGROUND
  The ketogenic diet was first used in refractory epilepsy of childhood in the early 1920s. It was forgotten when new antiepileptic drugs were introduced, but recently has been used again. Although its efficacy in the treatment of epilepsy, in some patients, is beyond doubt, its mechanism of action is still not clear. There are three types of diet: the classical diet with a proportion of 4:1 of long chain fatty acids, with MCT oil and with modified MCT oil.
  
  
  OBJECTIVE
  To present a protocol recently designed in our hospital. We include the type of diet, form of onset, subsequent follow up of complications, clinical and electroencephalographic response and side effects seen in the patients.
  
  
  METHODS
  Introduction of the ketogenic diet with MCT oil in six patients aged between 2 and 11 years, with various types of epilepsy, all resistant to treatment, who had been unsuccessfully treated for 28 months in one case and between 4 and 6 months in the others. We evaluated the response on the criteria of Huttenlocher and Panic electroencephalograms.
  
  
  RESULTS
  Two of the patients improved with good control of their disorder and the EEG became normal. No serious side effects were seen apart from gastrointestinal symptoms which improved when the quantity of MCT oil was reduced.
  
  
  CONCLUSIONS
  In patients with drug resistant epilepsy it is convenient to have a guideline for treatment using a ketogenic diet. It is also useful to have a multi disciplinary team for management, follow up to detect late side effects and obtain the cooperation of the patient s family in following the protocol.
authors.affiliation: Servicio Pediatría/ UCIP; Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950, España. campistol@hsjdbcn.org
authors.forename: M
authors.initials: M
authors.lastname: Galván Manso
authors.forename: M
authors.initials: M
authors.lastname: Arellano
authors.forename: A
authors.initials: A
authors.lastname: Sans
authors.forename: F X
authors.initials: FX
authors.lastname: Sanmartí
authors.forename: L
authors.initials: L
authors.lastname: Gómez
authors.forename: A
authors.initials: A
authors.lastname: Vernet
authors.forename: J
authors.initials: J
authors.lastname: Campistol
mesh_terms: D002648:Child; D002675:Child, Preschool; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D004569:Electroencephalography; D004827:Epilepsy / Q000178:diet therapy*; D005260:Female; D006801:Humans; D008297:Male
chemical_list: D004042:Dietary Fats, Unsaturated
vernacular_title: Dieta cetógena: ¿una alternativa válida en epilepsias refractarias?