Exogenous Ketone Esters for Drug Resistant Epilepsy

Epilepsy is a common neurological disorder among children with significantneurobiological, cognitive, psychological, and social consequences. Seizures can usuallybe controlled by anti‐seizure medications (ASMs) in up to two‐thirds of children withepilepsy. However, this leaves a significant part of epileptic children whose seizuresare not controlled by pharmacotherapy. Currently, available alternatives fordrug‐resistant epilepsy (DRE) include surgery, vagus nerve stimulation, and ketogenicdiet (KD).KD has been classically used for treating children with DRE. However, KD requires strictdietary restriction, which may not be applicable or acceptable for many patients, and isassociated with several adverse effects, commonly including gastrointestinal (e.g.,constipation, nausea, vomiting), cardiovascular (e.g., dyslipidemia), renal/genitourinary(e.g., renal calculi), and growth problems. Exogenous ketone esters (EKE) could be a moreconvenient and superior alternative to KD for children with DRE.