Altered Gut Microbiome as a Predictor of Response to the Ketogenic Diet in Pediatric Epilepsy

The ketogenic diet is an effective treatment for refractory epilepsy but the exact mechanism of action is not completely understood. Research in human and animal models propose that the ketogenic diet exerts its effects by modulating the gastrointestinal microbiome. Alterations in gut flora have also been linked to epilepsy, especially in non-responders. However, there are currently no studies that evaluate whether the ketogenic diet may be superior to standard pharmacologic regimens among patients with demonstrated abnormalities in gut flora composition who have failed to respond to a first line antiepileptic drug. In this randomized controlled trial, we evaluate the efficacy of the ketogenic diet as a treatment for pediatric epilepsy and an abnormal gastrointestinal microbiome. These results will provide a prognostic tool to guide treatment of epilepsy that does not respond to pharmacologic treatment and provide additional insight into the role of the gastrointestinal microbiome and the central nervous system