Alteration of Gut Microbiota by Ketogenic Diet as an Alternative Therapeutic Target for Drug-Resistant Epilepsy

As one of the most serious and widespread neurological disorders, epilepsy affects nearly 70 million people worldwide. In the development of this disease, significant alterations of gut microbiotas are often observed in the patients. During the treatment of drug-resistant epilepsy, which accounts for ~20-30% of cases, a ketogenic diet (KD), a diet containing high fat, adequate protein, and low carbohydrate, has been widely used and showed promising therapeutic effects. The underlying mechanisms of the neuroprotective effects of a KD have been suggested in recent studies to be connected to the gut microbiota, the composition of which is dramatically influenced by this treatment. In this review, we summarize the recent advances of the relationship between a KD, gut microbiota, and epilepsy, with an emphasis on the gut bacterial changes under KD treatment, hoping to delineate the gut microbiota as a potential therapeutic target in epilepsy.