There is a large body of evidence demonstrat-ing the efficacy of the metabolism-based therapies
for refractory seizures, with the majority focusing
on the classic ketogenic diet. Two meta-analyses of
observational studies showed that 15.6%–15.8%
of patients on the diet can achieve seizure freedom
whilst 33.0%–55.8% of the patients can have a .50%
reduction in number of seizures.
67
One of the only
randomized controlled trials to investigate the effi-cacy of the classic ketogenic diet followed children
with intractable or focal-onset epilepsy who were