Abstracts

The Ketogenic diet(KD) has been used in the treatment of intractable epilepsy since 1920s, but the complications of KD have been rarely reported in large study group. So, we studied the tolerability and the complications of KD in large group. This is a retrospective study in 40 children with intractable epilepsy, who were treated with the KD in the department of pediatrics, Asan medical center, from January 1996 to April 2004. The 40 children included 22 boys and 18 girls. The mean interval from diagnosis to initiation of the KD was 28 months(44 days-11.5 years), and the mean duration of the KD was 7 months(4 days-29 months). Thirty(75%) children discontinued the KD, because of refusal to eat(n=14, 47%), complications(n=10, 33%) and ineffectiveness(n=6, 20%). Complications were experienced in 15(38%) children; hyperlipidemia(n=5), elevated liver enzyme(n=5), gastrointestinal symptoms including vomiting and constipation(n=6), severe or recurrent infections(n=4), metabolic acidosis(n=2), hypoglycemia(n=2), hyperuricemia(n=1), renal stone and hematuria(n=1), hypoproteinemia(n=1). The development of metabolic acidosis was not related to the co-treatment with topiramate. KD is an effective therapeutic modality in the treatment of pediatric intractable epilepsy. However, variable complications may be accompanied. Education of parents and patients and careful observation about the development of complications are recommended.