Rationale:
Approximately 35% of patients with epilepsy are drug-resistant and recent anti-seizure medications have not proved effective in the long term. A therapeutic alternative is the ketogenic diet (KD), which involves redistribution of macronutrients, increasing fat intake, restricting carbohydrate intake and maintaining protein intake. However, to date, there are few studies on the effect of KD in reducing seizures since the studies carried out have been done primarily in children.
Methods:
Systematic review was conducted to identify studies evaluating the efficacy of the ketogenic diet in adult patients with refractory epilepsy. To carry out the meta-analysis, an analysis was carried out using the random effects method with the STATA v.17 program, using the RR as a comparison measure.
Results:
In the systematic review, seven articles were found, of which only three met the selection criteria for analysis. Meta-analysis: RR of 6.47 with 95% CI (1.6-26.11), favorable for the ketogenic diet in patients with drug-resistant epilepsy compared to pharmacological treatment only.
Conclusions:
The ketogenic diet is an option to reduce the frequency of seizures by at least 50% in adults with drug-resistant epilepsy. However, new clinical studies need to be carried out with representative samples and less heterogeneous methodologies.
Funding: MGNC and JGJ receive support from CONACyt.