The Role of Carnitine Monitoring and Supplementation in Children With Epilepsy on a Ketogenic Diet.

This article focuses on the monitoring and supplementation of carnitine in children with epilepsy undergoing ketogenic diet therapy (KDT) at a single pediatric center. Over eight years, 150 children treated with the classic ketogenic diet were evaluated, revealing that 70% had carnitine levels checked, with those on valproate showing lower baseline total carnitine levels. While free carnitine levels decreased over time in unsupplemented patients, total carnitine remained stable, and no significant overall improvement in seizure control was observed with carnitine supplementation, which was given to about one-quarter of patients. Approximately one-third of supplemented children showed modest benefits in ketosis or seizure reduction, suggesting that carnitine monitoring and supplementation may have individualized utility but lack clear evidence for broad efficacy in this population.