Ormond Street Hospital, London and National Centre for Young People with Epilepsy, Lingfield, UK.

The ketogenic diet has been used for thetreatment of epilepsy in children foralmost 100 years. Originally, it wasdetermined that individuals with seizures found benefit from starvation; subsequently a diet was proposed which was high in fat content, the breakdown of fat for energy producing ketones and therefore mimicking starvation(1). This was subsequently found to be effective in treating recurrent seizures. Many open label studies over the years suggested considerable benefit could be achieved in children with epilepsy; it went out of favor with the advent of anticonvulsants but further interest in the 1990s led to an increase in evaluation and use. However, despite the belief in its efficacy, repeatedly systematic reviews commented on the lack of randomized controlled data(2,3). It was only last year that the first randomized controlled tria