Abstracts

Rationale: The KD is an effective treatment option for intractable epilepsy, but its use in adolescents is limited due to its rigidness. Previous studies suggest that the low glycemic index diet (LGID) may be an effective alternative to the ketogenic diet (KD). We compared the efficacy and the tolerability of the LGID in comparison to the KD.Methods: We reviewed medical records of 122 children who were started on the LGID or on the KD at Severance children’s hospital between Jan. 1st 2014 and December 31st 2014. Among 122, 106 patients with high (> 80%) dietary compliance and an available follow-up were included. Sixty-nine received the KD while 37 received the LGID. The individual meal plan and the type of the diet were determined by the family after discussion with the physician. The primary endpoint was the seizure reduction at 3 months after the diet was initiated.Results: Mean age of the KD group (3.22 ± 2.95 years old) was lower than that of the LGID group (12.79 ± 5.74 years old, p = 0.001). In the KD group, 44 were male patients while in the LGID group, 23 patients were. Lennox-Gastaut syndrome was the most common epilepsy syndrome in the LGID group (32%m 12/37) as well as in the KD group (33%, 23/69). Of 37, after 3 months of the LGID, 8 became seizure free and additional 13 had a ≥50% seizure reduction. The efficacy of the LGID did not differ significantly from that of the KD group in which 28 became seizure free (p = 0.06) and additional 20 had a ≥50% seizure reduction (p = 0.2). During the initial 3 months, three (8%) withdrew from the LGID and five (7%) withdrew from the KD (p = 0.873).Conclusions: In this study, both the KD and the LGID effectively controlled the seizures. The short-term efficacy of the LGID was comparable to that of the KD. These findings support the use of the LGID in patients with intractable epilepsy.