Ketogenic Diet for Refractory Status Epilepticus

Inclusion Criteria:

- Patients 18 years and older in refractory status epilepticus (continuous or recurrent
seizures without return to baseline mental status between seizures, lasting > 30
minutes) placed on anesthetics/sedating agents (barbiturates or benzodiazepines)
after at least one first- and second-line agent failed to control seizures, and with
clinical and/or electrographic seizures following attempt to wean anesthetic/sedating
agents after 24 hours.

Exclusion Criteria:

1. Unstable metabolic condition

2. Hemodynamic or cardiorespiratory instability

3. Coagulopathy

4. Liver failure

5. Total cholesterol > 300 mg/dL

6. Inability to tolerate enteral feeds, including ileus

7. Pregnancy

8. Family refusal/no consent

9. Received any propofol infusions within 24 hours

10. Known fatty acid oxidation disorder or pyruvate carboxylase deficiency