Dietary therapies--an old idea with a new lease of life.

The ketogenic diet has been used for the treatment of epilepsy in childhood for almost 100 years. Although initial use was wide, the advent of antiepileptic drugs led to reduced utilisation. However, an apparently 'forgotten treatment' gained further popularity in the early 1990s when significant individuals gained benefit. This aside, although there are many open label trials to suggest benefit can be gained in children with drug resistant epilepsy it is only recently that definitive evidence from randomised controlled trials has become available. There continues to be a constant struggle with the demand for the resources required, and therefore availability and apparent management choice is limited.