Evidence map›Paper›PMID 41205102›Full record

SynthesisWorld journal of pediatrics : WJP2025

Efficacy and safety of ketogenic diets in drug-resistant epilepsy: a systematic review and meta-analysis.

Alzahra'a Al Matairi, Bara M Hammadeh, Omar Abuhashem, Hamza Anas Marzouk, Husam Aldean H Hussain, Majed Ghlailat, Muaath Ismail Abdullah Alsufi, Osama Aloudat

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in World journal of pediatrics : WJP, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alzahra'a Al MatairiFaculty of Medicine, University of Jordan, Amman, Jordan. alzhraaalmoutaire2004@gmail.com.
Bara M HammadehFaculty of Medicine, Albalqa' Applied University, Salt, Jordan.
Omar AbuhashemFaculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Hamza Anas MarzoukFaculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Husam Aldean H HussainFaculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Majed GhlailatFaculty of Medicine, University of Jordan, Amman, Jordan.
Muaath Ismail Abdullah AlsufiFaculty of Medicine, University of Jordan, Amman, Jordan.
Osama AloudatDepartment of Pediatrics of Saint, Louis University School of Medicine, SSM Health Cardinal Glennon Children's Hospital, Missouri, MO, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEpilepsy affects millions of patients worldwide, and approximately one-third of patients are resistant to antiepileptic drugs. Dietary therapies, such as ketogenic diet (KD), modified Atkins diet (MAD), and low glycemic index treatment, have shown potential in seizure control. This review aims to evaluate the effectiveness and safety of these dietary interventions in reducing seizure frequency and improving related outcomes in individuals with drug-resistant epilepsy.

methodsA comprehensive search of PubMed, Scopus, the Cochrane Library, and Web of Science was conducted up to December 2024 and updated in May 2025. Eligible studies were randomized controlled trials and prospective cohort studies evaluating KDs in patients with drug-resistant epilepsy. The primary outcomes included seizure reduction (≥ 50%, ≥ 90%, or complete cessation), whereas the secondary outcomes included cognitive function, quality of life, and adverse events. The risk of bias was assessed via the Cochrane Risk of Bias 2 tool. Meta-analyses were performed via R (version 4.3.2), with odds ratios (ORs) and 95% confidence intervals (CIs) calculated. Fixed- or random-effects models were applied on the basis of heterogeneity levels.

resultsDietary interventions significantly increased ≥ 50% seizure reduction [odds ratio (OR) = 3.46, 95% CI = 1.83-6.56] compared with standard care, with stronger effects in pediatric patients (OR = 10.93 vs. 2.54 in adults, P = 0.007). MAD outperformed standard care (OR = 4.04), whereas KD did not (OR = 1.83). For a ≥ 90% reduction, KD had greater efficacy (OR = 6.23) than MAD did (OR = 1.98). No significant difference was found for complete seizure resolution (OR = 1.19). Adverse events varied: constipation was most common with MAD (30.97%), whereas KD had higher rates of respiratory infections (42.77%, P < 0.0001 vs. MAD) and diarrhea (13.75% vs. 8.11%, P = 0.0017). Heterogeneity was substantial in most analyses (I

conclusionsKDs and MADs are effective in reducing seizures in patients with drug-resistant epilepsy, especially in children. However, claims of seizure freedom remain uncertain. Further high-quality trials are needed to compare diets and assess long-term safety.

Indexed as

Diet, KetogenicDrug Resistant EpilepsyChildHumansRandomized Controlled Trials as TopicTreatment OutcomeDrug-resistant epilepsyKetogenic dietLow glycemic index therapyModified Atkins dietSeizure freedomSeizure frequency reduction

Identifiers

PMID41205102

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.