The classic ketogenic diet, a high-fat, adequate-protein, very-low-carbohydrate therapy, is a widely used, mainstream, standard of care in the management of refractory epilepsy. It is difficult to imagine that the first poster presentation in history on this treatment at the American Epilepsy Society Annual Meeting was 30 years ago. This review highlights the resurgence of this nonpharmacologic treatment, invigorated by multicenter, collaborative research into its basic mechanisms of action, ideal clinical indications, flexible methods of initiation and maintenance, and expansion of use to infants, adults, and conditions other than epilepsy.
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