I have never understood the reluctance of neurologists to strongly recommend the ketogenic diet for patients with seizures. Studies strongly support it’s effectiveness and safety, many times above anticonvulsant meds.
In this particular study of infants with seizures, the average number of anticonvulsants was 3.6. 3.6 medications with unknown effects on the brain and brain development. 2/3 of the infants were responsive to the ketogenic diet. Why, why, why would this NOT be the first line approach to infantile spasms? Or, at the very least, initiated immediately along with AEDs. This goes for children and adults as well.