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Clinical experience of ketogenic diet on children with refractory epilepsy
Insights
The ketogenic diet, a medium chain triglyceride oil diet, significantly reduced seizure frequency in children with refractory epilepsy. Many patients experienced sustained seizure reduction even after discontinuing the diet, suggesting its therapeutic potential.
Area of Science:
- Neurology
- Pediatrics
- Nutritional Science
Background:
- Refractory epilepsy in children poses significant challenges.
- Alternative therapies are crucial for managing drug-resistant seizures.
Purpose of the Study:
- To evaluate the efficacy and side effects of the ketogenic diet in children with refractory epilepsy.
- To assess the impact of the ketogenic diet on seizure frequency and cognitive function.
Main Methods:
- A cohort of thirteen children with refractory epilepsy received a medium chain triglyceride oil-based ketogenic diet.
- Seizure patterns were documented, and efficacy was assessed by seizure frequency reduction.
- Side effects and cognitive improvements were monitored.
Main Results:
- 53.8% of patients experienced >75% seizure reduction, and 76.9% had >50% reduction after one month.
- Six patients showed improvements in cognitive function and/or school performance.
- Common side effects included weight loss and diarrhea; renal stones occurred in one patient.
Conclusions:
- The ketogenic diet is a viable alternative therapy for pediatric refractory epilepsy.
- Significant seizure reduction was observed, with sustained benefits even after diet cessation.
- The diet warrants consideration as a therapeutic trial for children with difficult-to-treat epilepsy.
Abstract:
Thirteen children with refractory epilepsy received a ketogenic diet (medium chain triglyceride oil diet) as an alternative therapy since September 1997. Their seizure patterns included (1) generalized tonic-clonic seizures, (2) myoclonic seizures, (3) generalized tonic + atonic seizures, (4) complex partial seizures, (5) generalized clonic + atonic + myoclonic seizures, (6) head nodding + myoclonic + gelastic seizures, and (7) generalized tonic-clonic + myoclonic + atonic seizures. Major concerns emphasized on the efficacy and side effects of the diet. Clinical observation one month after the diet revealed that 53.8% of the patients had a > 75% reduction in seizure frequency and 76.9% of the patients had a > 50% reduction in seizure frequency. Six patients had some degrees of improvement in cognitive function and/ or school performances. The most common side effects were body weight loss (n = 6) and diarrhea (n = 5). Others included bad temper (n = 1), abdominal cramps (n = 2), nausea (n = 2), bad body smell (n = 1), and renal stones (n = 1). Even after discontinuation of the diet, 61.5% of patients still had a > 50% reduction in seizure frequency. We concluded that the ketogenic diet deserves a trial in children with refractory epilepsy.