Ketogenic diet is a high fat, adequate protein and low carbohydrate diet that has been shown to be effective in reducing seizure frequency in some children. Though the diet and its effectiveness in seizure disorder was known as early as the Middle Ages, it was soon overshadowed by the introduction of anticonvulsants in the 1930s. Interest in ketogenic diet was rekindled in 1994, when a child with difficult- to- control seizures was successfully treated on the diet. Recent studies have shown that approximately half of children with seizures that don't respond to medications have a 50% or greater decrease in seizures
	The diet provides 4 grams of fat for every 1 gram of protein and carbohydrate; this is carefully calculated and individualized for every child. People on a ketogenic diet have to eat mostly fatty foods, such as butter, cream, and peanut butter. Foods such as bread, pasta, fruits, and vegetables have to be severely limited, and the person's total calories and fluids are also restricted. The diet is supplemented with vitamins and calcium..
	Te exact nature of how the diet works remains a mystery. The diet is designed to simulate the metabolic changes associated with starvation. During starvation, the body first utilizes its store of glucose and glycogen and then begins to burn the stored body fat. However, when there is not sufficient glucose available, as happens during starvation, the fats cannot be completely burned and ketone bodies are left, as the residue of incompletely burned fat. Ketogenic diets supply fats from outside, but limits the availability of glucose, hence ketone bodies build up. It is the high level of these ketones that appear to suppress seizures..
	The diet is usually recommended for difficult-to-treat seizures, i.e., individuals who have at least two seizures per week despite two appropriate trials of anticonvulsant medications. The diet is usually prescribed to children between the age groups of 1-16 years, efficacy in adults and children below the age of one year has not been ascertained
	The ketogenic diet is not a 'do-it-yourself' diet. It is a strict dietary regimen that is specifically designed for each individual child. The diet is initiated in a hospital and begins with a period of starvation; subsequent the dietary regimen is instituted. Strict adherence to the dietary protocol is important to avoid breakthrough seizures. Urinary levels of ketones are monitored; according to current standards urinary ketone levels have to be maintained at 4+. The diet can cause side-effects, which include dehydration, constipation, vomiting, kidney stones, behavior changes and slowed growth rates. If successful, the diet should be continued for a minimum of two years; recurrence of seizures associated with discontinuation of the diet can be controlled by reintroducing the dietary regimen.
	The diet, if adequately complied with, has been shown to be effective in not only medication-resistant seizures, but has also been shown to decrease the need for medications, i.e., enables a seizure-free and medication-free life.
	Key points:
	Ketogenic diet is effective and can be tried in children who are not responding adequately to anticonvulsants..
	One-third children might not show any response to the diet also.
	The diet should be initiated under medical care.
	The dietary regimen should be strictly adhered to and no change should be made without medical supervision.