What is epilepsy ?

People with epilepsy have abnormal brain activity. Epilepsy is characterized by recurrent, unpredictable, and unprovoked seizures.

There is a wide range of symptoms that a person with epilepsy can experience during a seizure4. The common symptoms of seizures are:

  • Changes in body movements
  • Involuntary twitching, stiffness, limpness, and convulsions
  • Sudden changes in awareness or confusion
  • Changes in behaviour that can include unusual sensations or thoughts
  • Staring off into space or confused

For 50% of adults and children with epilepsy, the cause of their epilepsy is unknown3.

There are many causes of epilepsy.

Some causes are known, and some are not. There are different kinds of changes in the body that cause epilepsy. These changes include:

  • Modified genes
  • Changes caused by injuries
  • Changes to the metabolic system
  • Changes to the immune system
  • Changes caused by infections

Epilepsy is a long-term disease. Some people will have it their entire lives. There is no cure. But epilepsy can be managed.

How to start and more about the medical ketogenic diet for epilepsy

The medical keto diet can be successful. It can help manage epilepsy symptoms when AEDs are not working. The keto diet must be strictly followed and requires careful measurements of calories, fluid, fat, protein, and carbohydrates. A clinician recommends the diet, and a dietitian will help you to get started on it.

The word “ketogenic” means that ketones are made or produced in the body.

  • keto=ketone
  • genic= producing


Ketones are produced from fats eaten and are what the brain uses as fuel. Usually the brain uses glucose or sugar from carbohydrates. In a ketogenic diet, the brain uses the ketones from fat as fuel. Ketones can also be produced during fasting.

The dietitian will determine the calories, protein and fat each individual should consume. On a “classic ketogenic diet”, all foods are weighed on a scale. The “ratio” of the food will be calculated by the grams of fat to the grams of combined carbohydrate plus protein. Your specific ratio is determined by your healthcare professional based on your age, weight and energy needs.

There are many versions of the keto diet. They are not as strict as the classical ketogenic diet. All diet variants can still help people manage their epilepsy symptoms. These diets are still high in fat and low in carbohydrates. More protein is allowed in some, and how you measure the carbohydrates in them varies. Calories are not monitored as closely in each diet variant but all must be followed with your healthcare team.

Other versions of the medical ketogenic diet include:

  • Modified Atkins diet (MAD)
  • Low glycemic index treatment (LGIT)
  • Medium-chain triglyceride (MCT) diet
  • Modified ketogenic diet


  1. World Health Organization. Epilepsy [Internet]. WHO; 2019 [updated 2019 June 20; cited 2021 May 15]. Available from: https://www.who.int/news-room/fact-sheets/detail/epilepsy
  2. Canadian Epilepsy Alliance. About Epilepsy [Internet]. CEA; 2021 [Cited 2021 June 23]. Available from: https://www.canadianepilepsyalliance.org/about-epilepsy/
  3. Epilepsy Canada. What is epilepsy? [Internet]. Epilepsy Canada; 2021 [Cited 2021 June 23]. Available from: https://www.epilepsy.ca/what-is-epilepsy
  4. Epilepsy Foundation. Types of seizures [Internet]. 2017 [updated 2017 March 20; cited 2021 May 21]. Available from: https://www.epilepsy.com/learn/types-seizures
  5. Epilepsy Foundation. Drug-Resistant Epilepsy [Internet]. 2020 [updated 2020 October 5; cited 2021 May 15]. Available from: https://www.epilepsy.com/learn/drug-resistant-epilepsy
  6. Kwan P et al. (2010) Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 51:1069-1077. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2009.02397.x/full
  7. Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC, Kelly LM. The efficacy of the ketogenic diet-1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358-63. Available from: https://pubmed.ncbi.nlm.nih.gov/9832569/
  8. Kossoff EH, Zupec-Kania BA, Amark PE, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the international ketogenic diet study group. Epilepsia. 2009;50(2):304-317. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1528-1167.2008.01765.x
  9. Ye F, Li XJ, Jiang WL, Sun HB, Liu J. Efficacy of and patient compliance with a ketogenic diet in adults with intractable epilepsy: a meta-analysis. Journal of clinical neurology (Seoul, Korea). 2015 Jan;11(1):26. Available from: https://thejcn.com/DOIx.php?id=10.3988/jcn.2015.11.1.26
  10. Barborka CJ. Epilepsy in adults: results of treatment by ketogenic diet in one hundred cases. Archives of Neurology & Psychiatry. 1930 May 1;23(5):904-14. Available from: https://jamanetwork.com/journals/archneurpsyc/article-abstract/644550
  11. Wilder R.M. High fat diets in epilepsy. Mayo Clin. Bull. 1921;2:308.

Our KetoCal® products

KetoCal is indicated for the dietary management of refractory epilepsy and is intended for use under medical supervision. Talk to your healthcare provider to determine if KetoCal is right for you.

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