FIGURE 3.

Auxiliary and alternative fuels and carbon sources for the brain. Several metabolic management approaches for epilepsy are highlighted with pink background, and their metabolic effects are indicated. This includes C4 ketone bodies, medium chain fatty acids (e.g., decanoate and octanoate), heptanoate, and C5 ketone bodies, which all directly produce acetyl‐CoA and do not require pyruvate dehydrogenase (PDH) for entry into the tricarboxylic acid (TCA) cycle. In addition, heptanoate and C5 ketone bodies also provide C4 TCA cycle intermediates by succinyl‐CoA. This anaplerosis may contribute to TCA cycling as well as biosynthesis of lipids and amino acids from TCA cycle intermediates. ATP, adenosine triphosphate; MCT, medium chain triglyceride; NADH, nicotinamide adenine dinucleotide