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Pediatric State of the Art Symposium | Metabolism-Based and Ketogenic Therapies for Epilepsy: A Translational Approach

Over the past decade, metabolism-based therapies, including the classic ketogenic diet (KD) along with pharmaceutical compounds based on this treatment, have experienced a remarkable explosion in global clinical growth and scientific research. As a result, interventional approaches based on an understanding of metabolic derangements in epileptic brain have evolved in a manner that has extended the traditional focus on diet alteration to now a broader framework more aptly termed "metabolism-based therapies." This symposium will provide a state-of-the-art update on the basic-translational science underlying all metabolism-based treatments, the co-morbidities of epilepsy that may be concurrently amenable to dietary and metabolic targeting, mounting clinical evidence and international consensus protocols for clinical implementation (particularly in the infant population), and the emerging use of the ketogenic diet in forms of refractory status epilepticus and related disorders associated with inflammatory brain disorders.

Learning Objectives

Following participation in this activity, learners should be able to:
  • Identify the key mechanisms thought to underlie the anti-seizure effects of the ketogenic diet
  • Appreciate how metabolic substrates and enzymes have rapidly become targets for experimental therapeutics and clinical development
  • Gain insights into the potential protective role of metabolism-based treatments against epilepsy co-morbidities such as SUDEP, sleep disorders, and autism spectrum disorder
  • Summarize and begin implementing evidence-based and expert opinion-guided protocols for successful and safe administration of ketogenic diets and its variants
  • Identify and treat patients with early-infantile epileptic encephalopathies who are candidates for metabolic treatments
  • Describe how the ketogenic diet has been used in the treatment of refractory status epilepticus and epilepsies arising from brain inflammation


Co-chairs: Eric H. Kossoff, MD, and Jong M. Rho, MD
Introduction: Eric H. Kossoff, MD
Cellular Metabolism as a Paradigm for Experimental Therapeutics in Epilepsy: Susan A. Masino, PhD
Metabolic Approaches for Treating Complications and Co-Morbidities of Epilepsy: Kristina A. Simeone, PhD
Clinical Evidence for Metabolism-Based Therapies in Children: Trials and Guidelines in 2018: Elizabeth J. Donner, MD, MSc, FRCPC
Ketogenic Diet for Infants? Results from the KIWE Study and Experience with Early Epileptic Encephalopathies: Anita May Devlin, MD, MRCP
Safety and Prevention of Risks from the Use of Metabolism-based Therapies: Robyn Blackford, RD, LDN
Are there Anti-Inflammatory Effects of Metabolic Treatments? Lessons from Refractory Status Epilepticus: Stephane Auvin, MD, PhD
Conclusions: Jong M. Rho, MD
Q&A and Panel Discussion

Target Audience

Clinical Trainee Student/Fellow, Neuropsychology/Behavioral Health, Basic Science/Scientists, Pediatric Neurologists/Clinician (MD/DO), Patients/Families, Nurses, Basic Science Trainee, Allied Health Professionals/Advance Practice Providers, Dietitians

Program Purpose

Knowledge, competence, performance

Career Stage

Early, mid-career, established