The effect of a ketogenic diet (KD) on kindled seizures and behavior in adult rats was studied at the Children’s Hospital, Harvard Medical School, Boston, MA. In a kindling model, KD provided transient protection against focal generation of seizures but not seizure spread. No change was noted in spatial learning and exploratory behavior tasks. [1]

COMMENT. The renewed interest in the clinical use of the ketogenic diet in the management of childhood epilepsy has stimulated further research in animal models. Some earlier studies of the effect of the KD on experimental seizures and seizure thresholds in laboratory animals showed that seizure susceptibility was not modified in normal animals, but an anticonvulsant effect of the KD was demonstrated in mice with seizure thresholds lowered by water intoxication and hypoelectrolytemia [2, 3]. In animals and in children with absence epilepsy, the anticonvulsant effect of the KD was unrelated to diuresis, independent of acidosis and ketosis, similar to the effects of acetazolamide, and correlated most closely with a negative balance of sodium and potassium. Additional animal models were reported by Uhlemann ER, Neims AH, 1972; Appleton DB, DeVivo DC, 1974; and Nakazawa M et al, 1983.

Nordli DR Jr, and De Vivo DC provide an editorial commentary [4]. Further projected objectives of clinical trials and experimental models are discussed. We know that the ketogenic diet works, but how can we offer the diet or its specific ingredient in a more practical form? Clinical metabolic and laboratory studies should help to achieve this goal.