Advances in ketogenic diet therapies in pediatric epilepsy

Ketogenic diets are high in fat, low in carbohydrates, and contain an adequate amount of protein. In addition to the classic ketogenic diet, three alternative types of ketogenic diet therapies (KDTs) have emerged. In addition to clarifying the indications for early treatment using KDTs, ongoing research over the past decades has led to the recognition of their contraindications and adverse effects. Recent studies focusing on the targeted therapeutic range of KDTs are expected to elucidate the precise mechanisms by which they alleviate certain epilepsy syndromes and other disorders. In this review, we discuss recent advances in KDTs, focusing on six issues: the selection of a specific KDT; the use of KDTs for febrile infection-related epilepsy syndrome and super-refractory status epilepticus; the use of KDTs for infants with refractory epilepsy; links between the gut-brain axis and KDTs; triheptanoin; and the use of KDTs for disorders other than pediatric epilepsy.