Abstract
Over the past years, the ketogenic diet (KD) has been increasingly used as emergency therapy for refractory and super-refractory status epilepticus (RSE/SRSE). The aim of this review was to evaluate the role of the KD in pediatric patients with RSE with a special focus on different types of status epilepticus. Over the past decade, several studies have been published on the use of the KD in children with RSE/SRSE. Based on our previous studies on dietary therapy in myoclonic status epilepticus and status epilepticus in epileptic encephalopathies, we consider the KD may work well in particular types of status epilepticus, especially those occurring in the epileptic encephalopathies. When patients with RSE/SRSE do not respond to benzodiazepines, IV antiepileptic drugs, and anesthetics, the KD may be an effective and tolerable option to be considered earlier in the treatment algorithm. The development of a consensus may optimize the use of this treatment in patients with epilepsy in critical care. There is a need for randomized controlled trials to confirm what children would be the best candidates for the use of the KD as well as the time of dietary therapy initiation for the treatment of RSE/SRSE.
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