To the editor.—
I am writing in regard to the following statement that appeared in the article entitled "Starvation and Seizures" by DeVivo et al (Arch Neurol 32:755-760, 1975): "The ketogenic diet was effective, particularly in children, but it was gradually discarded with the discovery of effective anticonvulsant drugs." We are in complete disagreement with the latter partof this statement, particularly as it pertains to myoclonic epilepsy of childhood, which is the principal indication for use of this diet.Childhood myoclonic seizures are refractory to the available anticonvulsant drugs, which, in our experience, have been unrewarding. We have not obtained beneficial results with the standard antiepileptic agents, ie, phenytoin (Dilantin), ethosuximide (Zarontin), methsuximide (Celontin), phenobarbital, primidone (Mysoline), and trimethadione (Tridione), nor with other drugs recommended by some physicians, eg, acetazolamide (Diamox), chlortetracycline hydrochloride (Aureomycin), and pyridoxine.In addition, our experience with the use of the benzodiazepines (clonazepam [Clonopin], diazepam [Valium], and
Livingston S. Starvation and Seizures. Arch Neurol. 1976;33(5):377. doi:10.1001/archneur.1976.00500050063026
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