Abstracts

The ketogenic diet has been used in the treatment of epilepsy for greater than eighty years and has recently seen an increase in interest. It is a nonpharmacologic therapy option predominantly used in the treatment of pediatric epilepsy. Studies show that fifty percent of patients become seizure free on the ketogenic diet. The Texas Children[apos]s Hospital electronic medical record was reviewed from 2001 for patients initiated on the ketogenic diet. Patient demographics, response to treatment, and tolerability were collected and analyzed. The results were compared to previous published results about the success of the ketogenic diet. Of the forty-seven patients reviewed in this study, 8% had cryptogenic localization-related epilepsy (n=4), 36% cryptogenic generalized epilepsy (n=17), 19% symptomatic localization-related epilepsy (n=9), 34% symptomatic generalized epilepsy (n=16), and 2% idiopathic generalized epilepsy (n=1). The average age of diet initiation was 6.4 years with a range of two months to nineteen years. Thirty one percent (n=15) of patients had a greater than 50% reduction in seizures, and 15% (n=7) were seizure free. Fifteen percent (n=7) did not tolerate the diet and were discontinued. Another 19% (N=9) were discontinued for lack of efficacy. Children with a symptomatic epilepsy syndrome did best with 40% (n=10) having at least a 50% reduction in seizures, and 20% (n=5) were seizure free. In addition, there was a suggestion that the generalized epilepsy syndromes responded better than the localization-related syndromes. This limited review suggests that the ketogenic diet can be effective in the management of intractable childhood epilepsy. Patients that appear to respond best are those with a symptomatic epilepsy syndrome as well as those with a generalized epilepsy syndrome.