The Role of the Ketogenic Diet in the Therapeutic Strategy for Childhood Epilepsy

Résumé

The role of the ketogenic diet in the therapeutic strategy for childhood epilepsy presents a structured medical synthesis of ketogenic dietary therapy in pediatric epilepsy. The book first explains the scientific foundations of the ketogenic diet, distinguishing therapeutic ketosis from popular weight-loss diets and detailing nutritional principles, ketogenic ratios, ketone metabolism, liver and mitochondrial roles, and possible mechanisms involving neurotransmission, GABA, oxidative stress, inflammation, microbiota and adipokines. It then reviews the clinical framework of childhood epilepsy, including seizure definitions, epilepsy classification, pediatric syndromes, diagnostic pathways, neonatal specificities, conventional antiseizure drugs, drug-resistant epilepsy and non-pharmacological alternatives such as epilepsy surgery and vagus nerve stimulation. The central section defines the place of ketogenic therapy in treatment strategy, with emphasis on drug-resistant epilepsy, West, Lennox-Gastaut, Doose and Dravet syndromes, GLUT1 deficiency, pyruvate dehydrogenase deficiency and selected mitochondrial diseases. Practical chapters guide patient selection, pre-diet assessment, diet initiation, monitoring, efficacy evaluation, adverse effects, supplementation and long-term follow-up. The book closes with family education, multidisciplinary care, digital support tools and practical appendices for compatible foods, menus, monitoring and emergencies. Its tone is scientific, clinical and educational, intended for health professionals, students, dietitians and pediatric neurology teams.