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Seizures decrease rapidly after fasting: preliminary studies of the ketogenic diet.

J M Freeman¹, E P Vining

¹Pediatric Epilepsy Center, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.

Archives of Pediatrics & Adolescent Medicine

|September 11, 1999

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The ketogenic diet significantly reduced seizures in children with Lennox-Gastaut syndrome. This study also demonstrated the feasibility of a blinded crossover trial for evaluating the ketogenic diet.

Area of Science:

Neurology
Pediatrics
Dietary Therapy

Background:

Lennox-Gastaut syndrome is a severe form of epilepsy characterized by atonic or myoclonic seizures.
The ketogenic diet is a high-fat, low-carbohydrate diet used to manage epilepsy.

Purpose of the Study:

To evaluate the efficacy of the ketogenic diet in reducing atonic or myoclonic seizures in children with Lennox-Gastaut syndrome.
To develop a blinded crossover study design for assessing the ketogenic diet's effectiveness.

Main Methods:

A before-after trial design was employed with 17 consecutively treated patients.
Patients underwent a 36-hour fast followed by a 3-day diet introduction.
Seizure frequency was monitored using parent-reported calendars and 24-hour ambulatory electroencephalograms.

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Main Results:

A more than 50% immediate decrease in atonic or myoclonic seizures was observed.
Ambulatory electroencephalograms confirmed a significant reduction in electroclinical seizure events.
Ketosis could be induced and reversed using glucose administration, demonstrating short-term dietary manipulation.

Conclusions:

The ketogenic diet is effective in reducing seizures associated with Lennox-Gastaut syndrome.
A blinded, crossover study is feasible for evaluating the ketogenic diet's efficacy in this population.
Short-term manipulation of ketosis is possible, supporting blinded study designs.