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The case here reported illustrates a relatively new complication—a dietary deficiency syndrome—due to poorly supervised ketogenic diet.
B. R., a woman, aged 20, single, the only child of living and healthy parents, was reared in comfortable circumstances. Her early development was uneventful except for whooping cough at 1½ years, and measles at 8 years. There was nothing relevant in the family history. Nocturnal convulsions were first observed at 14. Various methods of treatment were tried in her case. At 16 she was given glandular therapy in the form of whole gland pituitary substance and thyroid extract because her basal metabolic rate was —24 per cent and she was slightly overweight. At that time she presented some vaguely described neurologic signs; i. e., some cranial nerve involvement and positive Babinski reflex on the left. About this time her tonsils were removed. The convulsions gradually became more frequent, both nocturnal and diurnal.
Guthrie RH. PELLAGRA-LIKE SKIN LESIONS APPEARING IN THE COURSE OF A KETOGENIC DIET. JAMA. 1930;95(25):1912-1913. doi:10.1001/jama.1930.27210250002010a