But the real reason why keto plans fail most of us is that they're not sustainable for the long term. Holidays, vacations, work functions … there's likely at least one scenario in which you'll find yourself eating higher-carb foods. And the same reasons why we see immediate weight loss on carb-restricted diets is the same reason why we see immediate weight gain after adding a seemingly harmless sandwich back into the mix: The water weight comes back instantly with glycogen storage.
When you eat foods high in carbohydrates and fat, your body naturally produces glucose. Carbohydrates are the easiest thing for the body to process, and therefore it will use them first – resulting in the excess fats to be stored immediately. In turn, this causes weight gain and health problems that are associated with high fat, high carbohydrate diets (NOT keto).
Infants and patients fed via a gastrostomy tube can also be given a ketogenic diet. Parents make up a prescribed powdered formula, such as KetoCal, into a liquid feed.[18] Gastrostomy feeding avoids any issues with palatability, and bottle-fed infants readily accept the ketogenic formula.[30] Some studies have found this liquid feed to be more efficacious and associated with lower total cholesterol than a solid ketogenic diet.[3] KetoCal is a nutritionally complete food containing milk protein and is supplemented with amino acids, fat, carbohydrate, vitamins, minerals and trace elements. It is used to administer the 4:1 ratio classic ketogenic diet in children over one year. The formula is available in both 3:1 and 4:1 ratios, either unflavoured or in an artificially sweetened vanilla flavour and is suitable for tube or oral feeding.[50] Other formula products include KetoVolve[51] and Ketonia.[52] Alternatively, a liquid ketogenic diet may be produced by combining Ross Carbohydrate Free soy formula with Microlipid and Polycose.[52]
Hi 😀 yes I have a question, just starting this Keto diet, so we’re very new at this but my boyfriend had a heart attack 8 years ago so we need to be very careful to not get to high on fat with him. Can he still benefit from this diet. His Doctor said he needs to get some of his weight off he is having a hard time breathing. The Doctor said a low carb diet. But I, we would like to try the Keto diet.
Anticonvulsants suppress epileptic seizures, but they neither cure nor prevent the development of seizure susceptibility. The development of epilepsy (epileptogenesis) is a process that is poorly understood. A few anticonvulsants (valproate, levetiracetam and benzodiazepines) have shown antiepileptogenic properties in animal models of epileptogenesis. However, no anticonvulsant has ever achieved this in a clinical trial in humans. The ketogenic diet has been found to have antiepileptogenic properties in rats.[55]
I didn’t feel empty from their veggie pho, and my food-chef friend commented my rainbow salad smelled and looked tasty. Even the hard-boiled eggs were perfect and the juices complemented the plan from day to night. With fewer carbs for lower-insulin, I noticed an easier drop of sugar, at least while I was on the Keto meal plan complete with juices.
Here are a few of the most common side effects that I come across when people first start keto. Frequently the issues relate to dehydration or lack of micronutrients (vitamins) in the body. Make sure that you’re drinking enough water (close to a gallon a day) and eating foods with good sources of micronutrients. To read more on micronutrients, click here >
If you’re looking to get a jump start on your health and fitness goals this year, you may be thinking about trying the ketogenic diet. Maybe you’ve heard the phrase before — it’s a huge diet buzzword — but aren’t sure what it means. Here’s a primer: The ketogenic diet is an eating plan that drives your body into ketosis, a state where the body uses fat as a primary fuel source (instead of carbohydrates), says Stacey Mattinson, RDN, who is based in Austin, Texas.

If you haven't heard of biltong, they're those thick, flavorful strips of air-dried meat that put stringy, chewy, and additive-packed beef jerky to shame. These peppery little slabs are made from grass-fed beef, air-dried for 14 days, and spiced with a blend of cayenne and chili powder to add some heat without overwhelming your palate. They’re also sugar-free, full of protein, and super simple to toss in your bag.
Eggs are a healthy, nutrient-dense food that has been incorrectly maligned for years. Cholesterol in food doesn’t increase cholesterol in your blood, so eat eggs liberally – they’re packed with protein and lutein, and they fill you up for hours. Make a healthy omelet with some cheddar, crumbled breakfast sausage, and shredded spinach and you’re already looking at over 30g of protein, just for breakfast! Spinach is a great source of magnesium and potassium, too. Add some sea salt and you’ve got a big dose of electrolytes that are so vital to maintaining energy and staving off headaches. Get the recipe and instructions
It can be tricky calculating the precise kind of diet that leads to a long life. Part of the problem is that (thankfully) we don't live our lives in highly controlled laboratory conditions. Until that terrifying day arrives and we all become well-studied lab rats, we have to rely on long-term observational data, usually in the form of surveys, to know more about which diets are the best long-term plans.
Raw Coconut Butter — This is made from blended coconut meat, and provides us with a delicious way to get plenty of coconut fat without missing out on our favorite coconut flavors. Make sure the coconut butter you find has no added sugar — and, most importantly, don’t overdo it. Coconut butter is packed with calories which can slow your weight loss.
Eggs are a standout snack because they have one of the lowest energy-to-nutrient-density ratios of any food, as is noted in an article published in August 2016 in the journal Proceedings of the Nutrition Society. They’re rich in good fats (so long as you don’t skip the yolk!) and a solid source of high-quality protein: Each egg has 5 grams (g) of fat, 6 g of protein, and 0 g of carbohydrates, according to the Egg Nutrition Center. Plus, they’re inexpensive — about 20 cents per egg, the center says. Keep several hard-boiled eggs in your fridge, so you can easily grab one when you’re in need of a nutritious snack.
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
^ Jump up to: a b c d e f g h i j k l m n o p q r s Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Bergqvist AG, Blackford R, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009 Feb;50(2):304–17. doi:10.1111/j.1528-1167.2008.01765.x. PMID 18823325
Keto Smoothies and Shakes — Some of our favorite keto smoothies are the Peanut Butter Caramel Milkshake, Blueberry Banana Bread Smoothie, McKeto Strawberry Milkshake, Cucumber Spinach Smoothie, Blackberry Chocolate Shake, and Keto Tropical Smoothie. Feel free to add your favorite low-carb protein powder to your shake or smoothie to help you meet your protein needs and build muscle.
Insulin triggers include carbohydrates, sugars, excessive protein. Also, every time you eat, you trigger insulin – unless you eat fat only. Combining certain foods, in fact, really spikes insulin, such as combining protein with sugars—so meat with bread, meats with sugary condiments like ketchup, barbeque sauce, sweet chili sauce and chicken fingers—these are deadly for the blood sugar and really spike insulin like birthday cake. Also, certain compounds in fast food really spike insulin, especially MSG, which is added to all kinds of fast foods, not just Asian food.

Still, it can be hard to get enough fat when you first start this diet. Butter, nuts, coconut and olive oils, and fatty cuts of meat are all on the menu. However, don't go overboard with polyunsaturated fats like soybean, corn, or sunflower oil. Keto dieters who increase their intake of those fats often end up with gastrointestinal distress that causes them to jump ship.


Hi Mel, Assuming that your ranch dressing doesn’t have sugar added, you don’t need to worry too much about limiting it, but within reason. This is my homemade ranch dressing recipe, which has 0.9g net carbs per 2-tbsp serving. It would be hard to find a store bought one with much less than that, even though some round anything less than 1g down to 0g, which isn’t truly accurate. Also, keep in mind that if weight loss is your goal, some people find that too much dairy can cause a stall. Finally, make sure you aren’t using all your “available” carbs on ranch dressing – have it with some low carb veggies!

In this guide the only form of pure fat we use is butter. If possible, coconut oil would really be a nice upgrade. We couldn’t fit coconut oil into our $5 a day keto on a budget meal plan, but it’s cheap if you buy in bulk. Another good substitution would be olive oil or coconut oil and vinegar instead of the premade salad dressing. Most cheap premade dressings will use oils that are frowned upon on keto like canola or vegetable oil.
A short-lived increase in seizure frequency may occur during illness or if ketone levels fluctuate. The diet may be modified if seizure frequency remains high, or the child is losing weight.[18] Loss of seizure-control may come from unexpected sources. Even "sugar-free" food can contain carbohydrates such as maltodextrin, sorbitol, starch and fructose. The sorbitol content of suntan lotion and other skincare products may be high enough for some to be absorbed through the skin and thus negate ketosis.[30]

First reported in 2003, the idea of using a form of the Atkins diet to treat epilepsy came about after parents and patients discovered that the induction phase of the Atkins diet controlled seizures. The ketogenic diet team at Johns Hopkins Hospital modified the Atkins diet by removing the aim of achieving weight loss, extending the induction phase indefinitely, and specifically encouraging fat consumption. Compared with the ketogenic diet, the modified Atkins diet (MAD) places no limit on calories or protein, and the lower overall ketogenic ratio (approximately 1:1) does not need to be consistently maintained by all meals of the day. The MAD does not begin with a fast or with a stay in hospital and requires less dietitian support than the ketogenic diet. Carbohydrates are initially limited to 10 g per day in children or 20 g per day in adults, and are increased to 20–30 g per day after a month or so, depending on the effect on seizure control or tolerance of the restrictions. Like the ketogenic diet, the MAD requires vitamin and mineral supplements and children are carefully and periodically monitored at outpatient clinics.[47]

“I really believe that the more informed you are about the benefits of a healthy bite versus the chain reaction that you’re going to put into effect in your body when you take that bite — you just suddenly don’t want to make that choice for yourself anymore. It’s beyond willpower at that point; it’s become a desire to do something good for yourself.” — Christie Brinkley
One cup sliced cucumbers and 10 large olives makes for a great keto-friendly snack, with added benefits: “This is a great snack to help people in ketosis supplement their sodium levels." says Desiree Nielsen, R.D., author of Un-Junk Your Diet. When you're in ketosis, your body needs more sodium, and “without adequate sodium, people are at risk for dehydration, constipation, and more dangerous electrolyte imbalances," she adds.
I wanted to put it out there that I made this meal plan specifically with women in mind. I took an average of about 150 women and what their macros were. The end result was 1600 calories – broken down into 136g of fat, 74g of protein, and 20g net carbs a day. This is all built around a sedentary lifestyle, like most of us live. If you need to increase or decrease calories, you will need to do that on your own terms.
We understand not everyone in your family will be eating a low carb high fat (lchf) diet.  To adjust our keto recipes to fit a family who are not all eating a ketogenic diet, you may simply cook a side of carbohydrates along with our recipe.  A side of mashed potatoes, pasta, or rice will usually make a great accompaniment for our keto diet recipes so that you don't have to cook two separate meals - you will just avoid the carbohydrate portion.
Which leads us to your personality. You need to be VERY strong willed to follow this diet. It follows very strict rules and you need to be able to commit to this. It makes it hard to eat out with friends or eat with friends in general. It’s hard to find food that fits this diet in common restaurants, but and this takes us to the next point, your health goals might be more important.

If you haven't heard of biltong, they're those thick, flavorful strips of air-dried meat that put stringy, chewy, and additive-packed beef jerky to shame. These peppery little slabs are made from grass-fed beef, air-dried for 14 days, and spiced with a blend of cayenne and chili powder to add some heat without overwhelming your palate. They’re also sugar-free, full of protein, and super simple to toss in your bag.

In the worst form of diabetes (type 1), a condition called ketoacidosis can exist. This is completely different from ketosis. Ketoacidosis is a disease state where there is no more insulin and acids build up to high levels that are dangerous to one's health. But with ketosis, the pH in the body doesn't even get close to the high levels seen with ketoacidosis.

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All I can say is WOW! I am a week in on this Keto way of eating and came across this simple recipe. Gotta admit, I didn’t think I would like it…I LOVE IT! So easy to make…took me 20 minutes total! It was light, moist and delicious. I used one small loaf pan, doubled the ingredients and made the regular one and the cheese mix in. Can’t wait to share the rest with my co-workers…we are doing this together. Will be back to check for other recipes. Thank you!
These samosas are genius! The dough is made from almond flour and mozzarella cheese, but it doesn’t taste — or feel — cheesy at all. Inside, there’s a delicious veggie filling of cauliflower and onion, seasoned with garam masala, cumin, fresh ginger and other spices. These little keto snacks are perfect when you’re craving Indian food. They’ve got all the flavor without the carbs.

This recipe is from our e-book, 20 Low-Carb Instant Pot Pressure Cooker Recipes. In the e-book we call it “Better Than Crack Chicken”, which it really is! We switched up the seasoning a little (omitted the Ranch mix and added our own keto-friendly seasonings), and this takes it over the top in terms of deliciousness. Our e-book is now on sale on Amazon for just $4.99!
In regimented keto diets, only 10% of total calories per day (about a measly 20 grams!) come from carbs, 20% from protein, and a whopping 70% from fats. Since our bodies preferentially use carbs for energy, cutting them means we have to use something else to keep organs functioning. Our bodies then turn to the glucose stored in our muscles as glycogen for fuel.

For most people, this eating style is a significant departure from the diet that they are comfortable eating. Most of us build meals around lean protein and carbohydrates, not fat. So before you decide to adopt the diet, it's smart to evaluate keto meals plans and think about whether or not you think you can stick to it for the long term. For example, if you are an eater who loves to include plenty of fresh fruits and vegetables at every meal, you might not be able to maintain this eating style.
The classic ketogenic diet is not a balanced diet and only contains tiny portions of fresh fruit and vegetables, fortified cereals and calcium-rich foods. In particular, the B vitamins, calcium and vitamin D must be artificially supplemented. This is achieved by taking two sugar-free supplements designed for the patient's age: a multivitamin with minerals and calcium with vitamin D.[3] A typical day of food for a child on a 4:1 ratio, 1,500 kcal (6,300 kJ) ketogenic diet comprises:[27]

Drink lots of water. This is especially crucial on a low carb or keto diet. Why? When you eat carbohydrates, your body stores the extra as glycogen in the liver, where they are bound to water molecules. Eating low carb depletes this glycogen, which allows you to burn fat – but it also means you are storing less water, making it easier to get dehydrated. Instead of the traditional recommendation of 8 cups of water per day, aim for 16 cups when following a low carb lifestyle.
When a person goes off the ketogenic diet and regains much of their original weight, it’s often not in the same proportions, says Kizer: Instead of regaining lean muscle, you’re likely to regain fat. “Now you’re back to your starting weight, but you no longer have the muscle mass to burn the calories that you did before,” she says. “That can have lasting effects on your resting metabolic rate, and on your weight long-term.”
This bread has a few more carbs than you might be eating, but each bite is worth it, particularly if you have low potassium. The ingredients are simple: bananas (not too ripe), almond flour, walnuts, eggs, olive oil and baking soda. But you’ll be impressed by the scrumptious loaf that comes out of your oven. A warm slice of this with a pat of grass-fed butter makes a tasty keto snack or breakfast.
Another trigger of insulin is large quantities of protein. This was one of the issues with the Atkins diet. The optimum amount of protein per meal is about 3 to 6 ounces. Protein is needed for repairing and providing the raw material for muscle, tendons, joint cartilage, and even bone. Protein can also be used for fuel; however, too much protein triggers insulin which can be converted to sugar and then to fat. 
The brain is composed of a network of neurons that transmit signals by propagating nerve impulses. The propagation of this impulse from one neuron to another is typically controlled by neurotransmitters, though there are also electrical pathways between some neurons. Neurotransmitters can inhibit impulse firing (primarily done by γ-aminobutyric acid, or GABA) or they can excite the neuron into firing (primarily done by glutamate). A neuron that releases inhibitory neurotransmitters from its terminals is called an inhibitory neuron, while one that releases excitatory neurotransmitters is an excitatory neuron. When the normal balance between inhibition and excitation is significantly disrupted in all or part of the brain, a seizure can occur. The GABA system is an important target for anticonvulsant drugs, since seizures may be discouraged by increasing GABA synthesis, decreasing its breakdown, or enhancing its effect on neurons.[7]
Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions.[18] Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.[3]
Fiber isn't just good for keeping your gut moving — scientists feeding diets rich in fiber to mice are discovering that the carbs, which can't be absorbed by the body, can help protect aging brains from some of the damaging chemicals associated with Alzheimer's and reduce inflammation in the gut. They're confident that the health benefits of eating more fiber extend to humans too.
These nachos use the trendy Fat Head pizza crust as the “nachos” with a Tex-Mex twist, substituting cilantro, cumin and chili for the rosemary and garlic in the pizza base. After you cut them into tortilla shapes, you’ll load them with a meaty sauce and finish off the nachos with your favorite toppings, like guacamole, jalapeños and salsa. They’re the perfect snack to enjoy with family on movie night.
Please note that I am not a medical or nutritional professional. I am simply recounting and sharing my own experiences on this blog. Nothing I express here should be taken as medical advice and you should consult with your doctor before starting any diet or exercise program. I provide nutritional information for my recipes simply as a courtesy to my readers. It is calculated using MacGourmet software and I remove erythritol from the final carb count and net carb count, as it does not affect my own blood glucose levels. I do my best to be as accurate as possible but you should independently calculate nutritional information on your own before relying on them. I expressly disclaim any and all liability of any kind with respect to any act or omission wholly or in part in reliance on anything contained in this website.

Around this time, Bernarr Macfadden, an American exponent of physical culture, popularised the use of fasting to restore health. His disciple, the osteopathic physician Dr. Hugh William Conklin of Battle Creek, Michigan, began to treat his epilepsy patients by recommending fasting. Conklin conjectured that epileptic seizures were caused when a toxin, secreted from the Peyer's patches in the intestines, was discharged into the bloodstream. He recommended a fast lasting 18 to 25 days to allow this toxin to dissipate. Conklin probably treated hundreds of epilepsy patients with his "water diet" and boasted of a 90% cure rate in children, falling to 50% in adults. Later analysis of Conklin's case records showed 20% of his patients achieved freedom from seizures and 50% had some improvement.[10]


Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?

What's more, studies that have examined the efficacy of the ketogenic diet for weight loss have a few questionable similarities. First, they use the keto diet in conjunction with an extremely low-calorie plan (under 1,000 per day!), which makes it difficult to determine what caused the actual weight loss. Second, they all question the long-term impact on your heart of eating mostly saturated fat, not to mention how hard (and boring) it is to eat mainly coconut oil and butter for months on end.

I don’t normally eat a ton of eggs or chicken and stay mostly pescatarian. But I was trying to make an effort to eat more protein. Unfortunately I broke out in hives a few hours after forcing myself to eat the 2 hardboiled eggs provided for breakfast. Went to derm, who had me do a skin prick allergy test and lo and behold, allergic to eggs. (After 35 years on this earth eating the occasional omelette, and certainly many other things with eggs in them, this is surprise- but apparently eating an allergen on an empty stomach first thing is a great way to get the full effect of that allergen. Needless to say, I sadly threw out the rest of the eggs and my dog got a really nice couple of chicken & salmon dinners since I just could not stomach either after the first awful day. I’ve actually just ordered meta morphosis to reset after this Keto thing threw me off so badly. I do want to stress that I don’t fault Urban Remedy for this, I know Keto is trendy and they are responding to a diet plan that I know many people follow. I will continue to order, just never again this plan!
But the real reason why keto plans fail most of us is that they're not sustainable for the long term. Holidays, vacations, work functions … there's likely at least one scenario in which you'll find yourself eating higher-carb foods. And the same reasons why we see immediate weight loss on carb-restricted diets is the same reason why we see immediate weight gain after adding a seemingly harmless sandwich back into the mix: The water weight comes back instantly with glycogen storage.

Ketones are triggered by an absence of carbohydrates and sugar. There are specific steps to take to get your body into ketosis, but essentially, when carbohydrates are eliminated, the body will transfer over to using ketones. But I don’t recommend removing carbohydrates completely because I want you to be consuming lots of vegetables. One reason it is so crucial to take in lots of vegetables, and especially lots of vegetables high in potassium, such as kale, beet greens and collard greens, is because it will help you keep all this fat you’re dumping off the body off your liver. You can get a fatty liver when you start dropping lots of weight, as you will once you begin running on ketones instead of glucose. So think VEGETABLE CARBOHYDRATE ONLY.
Keto bombs are snacks that ketogenic dieters love because they’re healthy, delicious cheat foods that are high in fat, but virtually devoid of carbs and protein. I have a lot of videos on how to make keto bombs, but you don't have to have them with each meal. The goals would be to have one a day. Dumping a lot of butter or coconut oil into your coffee may not work for you. Some people can digest it, and some people can't.
Another common mistake that she sees is that people focus too much on macronutrients: "Micronutrients are really important too as ketosis is metabolically demanding and the diet is not nutritionally adequate most of the time." She says that most of her clients take multivitamins, carnitine supplements, calcium supplements and sometimes selenium or zinc.
Therein lies the problem, of course. You can’t just walk in to any store or restaurant and grab yourself some keto snacks. We are making progress on that front, for sure, but we’ve still got a ways to go. While there are a number of decent store-bought options like cheese, nuts, and hard-boiled eggs, there are potential pitfalls everywhere. Like beef jerky, which can often contain a startling amount of sugar and carbs.
What’s going on is your body is trying to adjust to fat burning. So, this is a good thing. What you need to do is concentrate on getting more vitamins in the diet. Now, the one nutrient you need a lot of to keep the fatigue away and to help you in the metabolism is B5. B5 also helps the adrenals and metabolism along, and keeps that fatigue away. Promise!

I get many questions about intermittent fasting, the health benefits, the weight loss benefits, and the like. People normally use intermittent fasting for both the energy and mental clarity it can offer. But it’s not just good for that. It can offer breakthroughs of plateaus and even benefits in nutrient uptake in exercise. We go more in depth to intermittent fasting in Week 3 and 4, so keep your eyes peeled!


The ketogenic diet is a medical nutrition therapy that involves participants from various disciplines. Team members include a registered paediatric dietitian who coordinates the diet programme; a paediatric neurologist who is experienced in offering the ketogenic diet; and a registered nurse who is familiar with childhood epilepsy. Additional help may come from a medical social worker who works with the family and a pharmacist who can advise on the carbohydrate content of medicines. Lastly, the parents and other caregivers must be educated in many aspects of the diet for it to be safely implemented.[5]
A lot of people take their macros as a “set in stone” type of thing. You shouldn’t worry about hitting the mark every single day to the dot. If you’re a few calories over some days, a few calories under on others – it’s fine. Everything will even itself out in the end. It’s all about a long term plan that can work for you, and not the other way around.
We seem to have breakfast, lunch and dinners figured out. But what about snacks? What about those moments where you’re sitting at your desk, or watching a movie, and your normal snacking is out the window with these low-carb dieting? Thankfully, Keto snacks are some of the best Keto-specific recipes out there. You’ll not only squash your cravings, but you’ll also be refueling with healthy fat snacks that will keep you going until dinner.
That is, until it's snack time—then, if you're on the keto diet, your'e basically SOL (unless, you know, you like having an entire steak for a snack). Think about it: All the best snacks are off limits on the keto diet (damn that fickle 70 percent fat, 25 percent protein, 5 percent carbs ratio). Granola bars, crackers, cookies—all off-limits on a keto diet.

Epilepsy is one of the most common neurological disorders after stroke,[7] and affects at least 50 million people worldwide.[8] It is diagnosed in a person having recurrent unprovoked seizures. These occur when cortical neurons fire excessively, hypersynchronously, or both, leading to temporary disruption of normal brain function. This might affect, for example, the muscles, the senses, consciousness, or a combination. A seizure can be focal (confined to one part of the brain) or generalised (spread widely throughout the brain and leading to a loss of consciousness). Epilepsy may occur for a variety of reasons; some forms have been classified into epileptic syndromes, most of which begin in childhood. Epilepsy is considered refractory (not yielding to treatment) when two or three anticonvulsant drugs have failed to control it. About 60% of patients will achieve control of their epilepsy with the first drug they use, whereas about 30% do not achieve control with drugs. When drugs fail, other options include epilepsy surgery, vagus nerve stimulation and the ketogenic diet.[7]
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