1例3岁女性癫痫患儿服用丙戊酸钠180 mg、1次/12 h,因效果欠佳,加用生酮饮食疗法。生酮饮食治疗前血氨为64μmol/L。生酮饮食第1～3天患儿饮食中脂肪与碳水化合物及蛋白质的比例由1∶1逐渐增加至3∶1,第4天调整为4∶1,血氨为63μmol/L。生酮饮食第7天患儿血氨升至95μmol/L,丙戊酸钠调整为120 mg、1次/12 h口服。生酮饮食第10天,丙戊酸钠减至60 mg、1次/12 h口服。第11天血氨为68μmol/L。生酮饮食第13天,继续减量服用丙戊酸钠。生酮饮食治疗期间,患儿癫痫发作控制良好。 A 3-year-old female with epilepsy took sodium valproate 180 mg once a day for 12 hours, due to poor effect, plus ketogenic diet therapy. Ketogenic diet blood ammonia treatment before 64μmol / L. Ketogenic diet 1 to 3 days in children with dietary fat and carbohydrate and protein ratio gradually increased from 1: 1 to 3: 1, 4 days to adjust to 4: 1, blood ammonia 63μmol / L. Ketogenic diet on the seventh day of blood ammonia increased to 95μmol / L, sodium valproate was adjusted to 120 mg, 1/12 h oral. Ketogenic diet on the 10th, valproate reduced to 60 mg, 1/12 h orally. Blood ammonia on the 11th day was 68 μmol / L. On the 13th day of ketogenic diet, we continued to reduce sodium valproate. Ketogenic diet during treatment, children with good control of seizures.