title: Dietary therapy is not the best option for refractory nonsurgical epilepsy.
abstract: 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.
authors.affiliation: Hospital Italiano Buenos Aires, Buenos Aires, Argentina.
authors.forename: María Magdalena
authors.initials: MM
authors.lastname: Vaccarezza
authors.affiliation: Hospital Italiano Buenos Aires, Buenos Aires, Argentina.
authors.forename: Walter Horacio
authors.initials: WH
authors.lastname: Silva
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D003337:Corpus Callosum / Q000601:surgery; D055423:Diet, Ketogenic / Q000379:methods* / Q000639:trends; D004827:Epilepsy / Q000628:therapy*; D006801:Humans; D055536:Vagus Nerve Stimulation
chemical_list: D000927:Anticonvulsants
keywords: Corpus callosotomy; Epilepsy; Ketogenic diet; New-generation antiepileptic drugs; Vagus nerve stimulation