Carnitine status of children treated with the ketogenic diet for intractable epilepsy

The ketogenic diet (KD) is a very high-fat and low carbohydrate diet that reduces seizure frequency in some children with epilepsy. The KD may increase risk for deficiency of carnitine, a nutrient required for fatty acid oxidation and ketone production. Although carnitine is supplemented during KD therapy by many medical centers, supplemental carnitine may be cost-prohibitive, poorly tolerated, and possibly unnecessary. This study aimed to evaluate: 1) the impact of the KD on plasma carnitine concentrations, 2) possible correlations between plasma carnitine and β9 hydroxybutyrate concentrations, and 3) the association between plasma carnitine concentration and reduction in seizure frequency and number of antiepileptic drugs (AEDs) prescribed.