Introduction and aims
The ketogenic diet is a nonpharmacologic treatment used for patients with medication refractory epilepsy, this diet contains a high proportion of fats and low of carbohydrates reproducing metabolic changes seen in fasting.
The aim of the study was to describe efficiency and tolerability of this diet in patients with refractory epilepsy  carried out in a pediatric  nutrition unit of a reference hospital in Madrid.
Methods
Retrospective observational study from July 2015 to September 2018, with revision of medical records (anthropometrical, analytical and clinical outcome) of patients with refractory epilepsy. Ketogenic diet treatment was carried out by doctors and dietist  specialised on pediatric nutrition.
Results
A total of 12 patients, median age of 7,5 years (range 1,5-16), was included, 58% male. The median duration of the diet was 5 months (range 1-14). 33% of patients started the diet during admission for treatment of an epilepticus status. 
The Ketogenic diet most frequently used was Atkins modified in 50% of the cases. 67% showed an improvement in the crisis control, no epileptical status were registred during the follow up. 75% of children showed cognitive and conductual improvement with the diet. Just a 17% gave up the diet because of lacios compliance. No major adverse effects were founded. Constipation was present in 42% of the cases.
Conclusions
The Ketogenic diet proved to be an effective treatment in refractory epilepsy. It achieves an effective control of the crisis and improves congnitive and conductual levels.
It should be applied earlier in patients treated unsuccessfully with two or more antiepileptyc drugs.

EFFICIENCY OF KETOGENIC DIET ON PATIENTS WITH REFRACTORY EPILEPSY.