There are no rules about who is and who is not a candidate for the diet. The greatest experience and reports of success are with children between ages 18 months to 6 years whose seizures cannot be controlled by antiepileptic drugs. The best results are in children with Lennox-Gastaut syndrome who have atonic, tonic, and myoclonic seizures, but all types of seizures can improve.
Its success depends on the child’s previous diet, adaptability, and motivation. After the age of 3 to 5 years, children have usually been exposed to foods that they are unwilling to part with. Children and adolescents need to be highly motivated to stay on the diet. For sensitive patients, eating small amounts of additional carbohydrates can lead to loss of seizure control.
Many parents are hesitant to use the ketogenic diet because their child is a carbohydrate lover or picky eater who barely eats enough. For children with severe epilepsy, the potential benefits of a 1-3 month trial far outweigh the risks.
Infants who are only fed with formula or children who are only fed with a gastrostomy tube can be easily put on the ketogenic diet. This diet can be used successfully in adults, who usually comply better with a modified Atkins or low glycemic diet better.