Dietary, Psychological and Complementary Therapies

Dietary approaches to epilepsy treatment have been employed since ancient times. The ketogenic diet was used to treat epilepsy in the early twentieth century before the emergence of effective antiseizure medications. The last few decades have witnessed a resurgence in the use of the ketogenic diet and its variations, with evidence for efficacy in childhood epilepsy across a wide range of disorders from inborn errors of metabolism to drug-resistant epilepsy and status epilepticus. There is emerging evidence to support its use in adults. The biological mechanisms through which the ketogenic diet exerts its effects remain largely unknown. Psychological, complementary and alternative therapies for epilepsy may increase well-being, improve mood and reduce stress, but current evidence does not support their use to treat seizures.