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Dr. Eric Kossoff, MD

Dr. Kossoff received his medical degree from SUNY at Buffalo School of Medicine in New York. He went on to complete a residency in pediatrics at Eastern Virginia Medical School in Norfolk, Virginia. He completed a second residency in child neurology and a fellowship in pediatric epilepsy and clinical neurophysiology at The Johns Hopkins Hospital in Baltimore, Maryland.

He is a professor of neurology and pediatrics at Johns Hopkins Children's Center and focuses on the diagnosis and treatment of childhood seizures and epilepsy, particularly treatments other than medications, such as diet, neurostimulation, and surgery. Specific interests include the ketogenic diet, the modified Atkins diet for children and adults, infantile spasms, hemispherectomy, the interaction of migraine headaches with epilepsy, and Sturge-Weber syndrome.

Dr. Kossoff is also very involved in teaching and is the director of the Pediatric Neurology Residency Program. He is a coauthor of Treatment of Pediatric Neurologic Disorders and the 5th (and upcoming 6th) editions of Ketogenic Diets. He has been the editor of "Keto News" on epilepsy.com since 2007 and is considered one of the world experts on dietary treatment for epilepsy.

Books by Dr. Eric Kossoff, MD

Video Presentations of Dr. Eric Kossoff, MD

"A Century of Progress: Ketogenic Diets for Epilepsy in Children and Adults" - Dr. Eric Kossoff

Dr. Kossoff received his medical degree from SUNY at Buffalo School of Medicine in New York. He went on to complete a residency in pediatrics at Eastern Virginia Medical School in Norfolk, Virginia. He completed a second residency in child neurology and a fellowship in pediatric epilepsy and clinical neurophysiology at The Johns Hopkins Hospital in Baltimore, Maryland.

He is a professor of neurology and pediatrics at Johns Hopkins Children's Center and focuses on the diagnosis and treatment of childhood seizures and epilepsy, particularly treatments other than medications, such as diet, neurostimulation, and surgery. Specific interests include the ketogenic diet, the modified Atkins diet for children and adults, infantile spasms, hemispherectomy, the interaction of migraine headaches with epilepsy, and Sturge-Weber syndrome.

Dr. Kossoff is also very involved in teaching and is the director of the Pediatric Neurology Residency Program. He is a coauthor of Treatment of Pediatric Neurologic Disorders and the 5th (and upcoming 6th) editions of Ketogenic Diets. He has been the editor of "Keto News" on epilepsy.com since 2007 and is considered one of the world experts on dietary treatment for epilepsy.

Dr. Eric Kossoff on Ketogenic Diet Therapy for Epilepsy

Dr. Eric Kossoff is one of the world's leading experts on ketogenic dietary therapy for neurological disorders. His research and clinical practice focus on the diagnosis and treatment of childhood seizures and epilepsy, and in 2003 he developed the Modified Atkins Diet for both kids and adults.

"Ketogenic Diet Therapy for Epilepsy Across the Ages" - Dr. Eric Kossoff, MD and Dr. Mackenzie Cervenka, MD

2nd Annual Conference on Nutritional Ketosis and Metabolic Therapeutics 

February 2017, Tampa, FL

"Ketogenic Diets and Seizure Management" - Dr. Eric Kossoff

Filmed at the Emerging Science of Carbohydrate Restriction and Nutritional Ketosis, Scientific Sessions at The Ohio State University

An impressive body of scientific evidence over the last 15 years documents long term benefits of carbohydrate-restricted, especially ketogenic, diets. We now understand molecular mechanisms and why they work. Popular books and articles now challenge the advice ‘carbohydrates are good and fats are bad.’ Circa mid-19th century urinary ketones were identified in diabetics sealing their toxic label for the next 150 years. Despite work four decades ago showing ketones were highly functional metabolites, they are still misidentified as toxic byproducts of fat metabolism. The vilification of fat by regulatory and popular dogma perpetuates this myth. But the nutrition-metabolic landscape is improving dramatically.

A growing number of researchers have contributed to what is now a critical mass of science that provides compelling clinical evidence that ketogenic diets uniquely benefit weight loss, pre-diabetes, and type-2 diabetes. In the last five years, basic scientists have discovered that b-hydroxybutyrate (BHB), the primary circulating ketone, is a potent signaling molecule that decreases inflammation and oxidative stress. BHB has been suggested to be a longevity metabolite, with strong support from recently published mouse studies showing decreased midlife mortality and extended longevity and healthspan. Although type-2 diabetes is often described as a chronic progressive disease, emerging evidence indicates that sustained nutritional ketosis can reverses the disease. There is growing interest in studying potential therapeutic effects of ketosis on cardiovascular diseases, cancer, and neurodegenerative diseases including Alzheimer’s and Parkinson’s. There are even reasons certain athletes may benefit from nutritional ketosis and ketone supplements ─ debunking the long-standing dogma that high carbohydrate intake is required to perform optimally.

"Ketogenic Diets and Epilepsy" - with Dr. Eric Kossoff 

Ketogenic diets have been used to treat seizures for 100 years. Dr. Eric Kossoff talks about the history of keto diets as well as the current status. We discuss how these concepts apply to kids and adults, and what else it can tell us about the safety and utility of ketosis.

"Dietary Therapy for Epilepsy: Current Status and Future Directions" - Dr. Eric Kossoff, MD

Dr. Eric Kossoff is a Professor of Neurology and Pediatrics at Johns Hopkins University in Baltimore, MD. He received his medical degree from SUNY at Buffalo School of Medicine in New York, followed by a residency in pediatrics at Eastern Virginia Medical School in Norfolk, Virginia. He completed a fellowship in child neurology and then pediatric epilepsy and clinical neurophysiology at The Johns Hopkins Hospital in Baltimore. He has been at Johns Hopkins since 1998. His research and clinical practice focuses on the diagnosis and treatment of childhood seizures and epilepsy, particularly treatments other than medications such as diet, neurostimulation and surgery. Currently the Medical Director of the Ketogenic Diet Center at Johns Hopkins, he is a world expert on the ketogenic diet and created the modified Atkins diet for children and adults in 2003. He is dedicated to bringing the use of diet therapies for neurologic disorders to the entire world and is the head of a Task Force within the International League Against Epilepsy to help achieve this goal. He is a coauthor of Ketogenic Diets: Treatments for Epilepsy and Other Disorders. Dr. Kossoff is also published in the fields of Sturge-Weber syndrome, the interaction between migraine and epilepsy in children, infantile spasms, Doose syndrome, and benign rolandic epilepsy. Dr. Kossoff is also very involved in teaching and mentorship and is the Director of the Pediatric Neurology Residency Program at Johns Hopkins.

Scholarly Articles from Dr. Eric Kossoff, MD

Phase I/II multicenter ketogenic diet study for adult superrefractory status epilepticusObjective: To investigate the feasibility, safety, and efficacy of a ketogenic diet (KD) for superrefractory status epilepticus (SRSE) in adults. Methods: We performed a prospective multicenter study of patients 18 to 80 years of age with SRSE treated with a KD treatment algorithm. The primary outcome measure was significant urine and serum ketone body production as a biomarker of feasibility. Secondary measures included resolution of SRSE, disposition at discharge, KD-related side effects, and long-term outcomes. Results: Twenty-four adults were screened for participation at 5 medical centers, and 15 were enrolled and treated with a classic KD via gastrostomy tube for SRSE. Median age was 47 years (interquartile range [IQR] 30 years), and 5 (33%) were male. Median number of antiseizure drugs used before KD was 8 (IQR 7), and median duration of SRSE before KD initiation was 10 days (IQR 7 days). KD treatment delays resulted from intravenous propofol use, ileus, and initial care received at a nonparticipating center. All patients achieved ketosis in a median of 2 days (IQR 1 day) on KD. Fourteen patients completed KD treatment, and SRSE resolved in 11 (79%; 73% of all patients enrolled). Side effects included metabolic acidosis, hyperlipidemia, constipation, hypoglycemia, hyponatremia, and weight loss. Five patients (33%) ultimately died. Conclusions: KD is feasible in adults with SRSE and may be safe and effective. Comparative safety and efficacy must be established with randomized placebo-controlled trials. Classification of evidence: This study provides Class IV evidence that in adults with SRSE, a KD is effective in inducing ketosis. DSMB= : Data and Safety Monitoring Board; GCS= : Glasgow Coma Scale; IQR= : interquartile range; KD= : ketogenic diet; MAD= : modified Atkins diet; mRS= : modified Rankin Scale; RSE= : refractory status epilepticus; SE= : status epilepticus; SRSE= : superrefractory status epilepticus
Ketogenic diet for adults in super-refractory status epilepticusObjective: To describe a case series of adult patients in the intensive care unit in super-refractory status epilepticus (SRSE; refractory status lasting 24 hours or more despite appropriate anesthetic treatment) who received treatment with the ketogenic diet (KD). Methods: We performed a retrospective case review at 4 medical centers of adult patients with SRSE treated with the KD. Data collected included demographic features, clinical presentation, diagnosis, EEG data, anticonvulsant treatment, and timing and duration of the KD. Primary outcome measures were resolution of status epilepticus (SE) after initiation of KD and ability to wean from anesthetic agents. Results: Ten adult patients at 4 medical centers were started on the KD for SRSE. The median age was 33 years (interquartile range [IQR] 21), 4 patients (40%) were male, and 7 (70%) had encephalitis. The median duration of SE before initiation of KD was 21.5 days (IQR 28) and the median number of antiepileptic medications used before initiation of KD was 7 (IQR 7). Ninety percent of patients achieved ketosis, and SE ceased in all patients achieving ketosis in a median of 3 days (IQR 8). Three patients had minor complications of the KD including transient acidosis and hypertriglyceridemia and 2 patients ultimately died of causes unrelated to the KD. Conclusion: We describe treatment of critically ill adult patients with SRSE with the KD, with 90% of patients achieving resolution of SE. Prospective trials are warranted to examine the efficacy of the KD in adults with refractory SE. Classification of evidence: This study provides Class IV evidence that for intensive care unit patients with refractory SE, a KD leads to resolution of the SE. AED= : antiepileptic drug; GCS= : Glasgow Coma Scale; ICU= : intensive care unit; IQR= : interquartile range; KD= : ketogenic diet; LOS= : length of stay; MAD= : modified Atkins diet; RSE= : refractory status epilepticus; SE= : status epilepticus; SRSE= : super-refractory status epilepticus