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In epilepsy, ketogenic dietary therapy is an established treatment, particularly for infantile, refractory, and metabolic epilepsies such as glucose transporter type 1 (GLUT1) deficiency and pyruvate dehydrogenase deficiency, where ketosis may reduce seizure frequency and severity, potentially via enhanced mitochondrial efficiency and dampened excitatory synaptic transmission, although mechanisms remain incompletely understood [67, 69, 70, 71]

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