The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
it was probably working through a mechanism independent of any anti-seizure compound because the ketogenic diet worked when drugs failed you know suggesting it was working through a different mechanism or many mechanisms kind of in synchrony
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So nutritional ketosis achieved through a dietary means with a low-carbohydrate, high-fat diet has therapeutic effects for a broad range of neurological disorders, in particular, seizures.
And I think that becomes the reason why the ketogenic diet works when drugs fail because you have drugs work through a GABAergic mechanism, these drugs work through suppressing glutamate. You have a variety of anti-epileptic drugs that work through different pathways, but combinations of them used in high dose often work initially then they fail, and then patients are put on a ketogenic diet and it works.
And I think that becomes the reason why the ketogenic diet works when drugs fail because you have drugs work through a GABAergic mechanism, these drugs work through suppressing glutamate.
So, the ketogenic diet works through many different mechanisms in synergy, and one of them is GABA.
The etiology of epilepsy is largely unknown, and the ketogenic diet seems to work through all these different types of epilepsy, whether it's like tonic-clonic, there's Dravet syndrome, there's different metabolic disorders, absence seizures. And the ketogenic diet seems to work across all these different seizure types probably because working through all these different mechanisms.