The high-fat or "ketogenic" diet was first used in treating epilepsy in 1921.1 Subsequent studies led to the frequently quoted empirical generalization that about 30% of properly selected epileptic children will have their seizures controlled while on the diet, an additional 30% will show improvement in the frequency of seizures, and 40% will be uninfluenced. The August issue of the Archives of Neurology contains the results of a study evaluating changes in plasma-partitioned lipids and other substances, in children on regular and on high-fat diets.2 The report also discusses the relationship between seizure frequency and induced changes in plasma constituents.
Eleven children with frequent and uncontrollable daily seizures were maintained on a high-fat diet for prolonged periods. In most instances, the ratio of fat to protein-plus-carbohydrates ranged between 4:1 and 3:1. In five of the children, the attacks ceased completely; in four, the improvement in seizure control was