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A short-lived increase in seizure frequency may occur during illness or if ketone levels fluctuate. The diet may be modified if seizure frequency remains high, or the child is losing weight. Loss of seizure-control may come from unexpected sources. Even "sugar-free" food can contain carbohydrates such as maltodextrin, sorbitol, starch, and fructose. The sorbitol content of suntan lotion and other skincare products may be high enough for some to be absorbed through the skin and thus negate ketosis.
Note that the term “reversal” in this context simply means that the disease gets better, improving glucose control and reducing the need for medications. In the best case, it can be so much improved that blood glucose returns to normal without medication, long term. In this context, reversal means the opposite of the disease progressing or getting worse.