PURPOSE OF REVIEW: Despite myriad anticonvulsants available and in various 
stages of development, there are thousands of children and adults with epilepsy 
worldwide still refractory to treatment and not candidates for epilepsy surgery. 
Many of these patients will now turn to dietary therapies such as the ketogenic 
diet, medium-chain triglyceride diet, modified Atkins diet, and low glycemic 
index treatment.
RECENT FINDINGS: In the past several years, neurologists are finding new 
indications to use these dietary treatments, perhaps even as first-line therapy, 
including infantile spasms, myoclonic-astatic epilepsy (Doose syndrome), Dravet 
syndrome, and status epilepticus (including FIRES syndrome). Adults are also one 
of the most rapidly growing populations being treated nowadays; this group of 
patients previously was not typically offered these treatments. In 2009, two 
controlled trials of the ketogenic diet were published, as well as an 
International Expert Consensus Statement on dietary treatment of epilepsy. 
Ketogenic diets are also now being increasingly studied for neurological 
conditions other than epilepsy, including Alzheimer's disease and cancer. 
Insights from basic science research have helped elucidate the mechanisms by 
which metabolism-based therapy may be helpful, in terms of both an 
anticonvulsant and possibly a neuroprotective effect.
SUMMARY: Dietary therapy for epilepsy continues to grow in popularity worldwide, 
with expanding use for adults and conditions other than epilepsy.