Treatment of Medically Refractory Epilepsy with Ketogenic Diet, Study of 50 Children.
Abstract number :
3.153
Submission category :
Year :
2001
Submission ID :
2797
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
E.A. Simon, MD, Neurology, Children[ssquote]s Hospital, Seattle, WA; M.A. Sotero de Menezes, MD, Neurology, University of Washington, Seattle, WA
RATIONALE: Ketogenic diet (KD) has been used in the treatment of medically refractory epilepsy for over 80 years, The present study evaluates the efficacy and side-effects of the KD in 50 children.
METHODS: Fifty patients, ages 14 months to 20 years, with medically refractory epilepsy were started on the KD. Thirty-eight subjects were also on antiepileptic drug polytherapy. The KD was initiated after fasting the subjects for 48 hours or until large ketones were detected in the urine. This was followed by gradual introduction of a 4:1 diet over three days. Antiepileptic medication schedules were not changed unless successful seizure control was obtained. Follow-up ranged from 1 month to 65 months (mean follow-up 19 months).
RESULTS: Forty percent of the children had more than 75% seizure reduction. Eight patients (16%) had good control initially followed by an increase in seizure frequency. Sixteen patients (32%) did not have seizure improvement. Renal stones occurred in 5 patients (10%), constipation in 15 (30%), severe weight loss in 2, decreased growth rate in 2 and severe metabolic acidosis in one. Fifty percent had hypercholesterolemia and/or hypertriglyceridemia. Eight patients (16%) had poor compliance with KD and 3 patients had to discontinue the diet by other medical problems (6%).
CONCLUSIONS: We conclude that children with medically refractory epilepsy may benefit from KD treatment. Serious side-effects may be seen in up to 16% of the cases. Further prospective studies are necessary to determine the long-term outcome of KD.