Introduction:

The ketogenic diet (KD) is used to treat persons with uncontrolled epilepsy. One proposed mechanism of KD is the elevation of polyunsaturated fats (PUFA) resulting in increased resistance to seizures in ketotic brain tissue. The PUFA-enriched KD may achieve a greater level of ketosis than a traditional KD .

We hypothesized that a PUFA enriched KD would help attain a greater degree of seizure control as compared to mixed fats KD (MFKD).

Method:

This was a prospective open, non-blinded study of 27 patients of age 11 months to 16 yrs (mean= 7yrs) who had inadequate seizure control on MFKD. They were changed to high PUFA KD. MFKD consists of 32.1% PUFA while PUFAKD consists of 73% PUFA.

Results:

A total of 10 (out of 27) patients had more than 90% reduction (of these 3 had 100% reduction) with a responder rate of 66% (> 50% reduction).  No serious side-effects were seen.

Conclusion:

PUFA KD could be tried in those who fail classical MFKD. Out of the four trials to date in one 5 out of 21 had a greater than 50% reduction in seizures while in three there was no change. A randomized control trial of PUFAKD against MFKD would help to decide whether PUFAKD should be used routinely in preference to MFKD.

Other studies gave lesser or no improvement. This is probably because the period was too short or the amount of PUFA was inadequate.