Scientists Crack How Keto Diet Stops Seizures After 100 Years

For nearly a century, doctors have watched the ketogenic diet work miracles for epilepsy patients when medications failed, but they never quite knew why. Now scientists at the University of Virginia have solved the mystery, and their discovery could change treatment for millions.

The breakthrough centers on a molecule called β-hydroxybutyrate, which the body produces when following the high-fat, low-carb keto diet. Researcher Jaideep Kapur and his team found this molecule interacts with a specific cellular receptor to calm overexcited brain cells that trigger seizures.

The keto diet has helped people with medication-resistant epilepsy since the 1920s, but its extreme restrictions make it nearly impossible for many patients to maintain. Some can't tolerate the high fat content, while others struggle with side effects like digestive problems.

Kapur's team mapped the receptor, called HCAR2, throughout the hippocampus where seizures often start. They discovered it concentrates in specific cell types already linked to seizures and in immune cells that protect the brain.

The real excitement comes from what happens next. Understanding how keto works means scientists can now develop drugs that deliver the same brain benefits without forcing patients to give up carbohydrates and sweets entirely.

Early research in mice suggests vitamin B3, commonly known as niacin, might provide similar benefits by targeting the same receptor. The vitamin is already FDA-approved for lowering cholesterol, which could speed up testing for seizure treatment.

Why This Inspires

This discovery matters far beyond epilepsy. Overactive neurons appear in early Alzheimer's disease, autism, and other conditions, meaning HCAR2-targeting drugs could potentially help with multiple brain disorders.

The research team is now exploring how this receptor affects brain immune responses, potentially opening treatment pathways for multiple sclerosis and Parkinson's disease. Their findings appeared in the journal Annals of Neurology this month.

For patients who've spent years avoiding birthday cake and pasta just to control their seizures, the possibility of medication that works the same way represents genuine freedom. Science just needed 100 years to catch up with what their bodies already knew.