[Complications of treatment of epilepsy by a ketogenic diet]

It was originally claimed that the ketogenic diet (KC) caused no major adverse effects. Few studies have been done to analyze the side effects and complications of the KC.

To analyze the side effects and complications seen in a group of patients on KC compared with those described in the international literature.

We made a prospective evaluation of 22 patients aged between one and nineteen years, over an average period of 25 months. All had some type of refractory epilepsy and had been included in a group treated following classical KC guidelines.

The side effects and complications during admission were delay in onset of the ketotic state (10.5%), intolerance of the rapid onset of ketosis (21%), hypoglycaemia (47.37%), refusal to drink fluids (15.79%), lack of appetite (15.79%), and nausea and vomiting (26.31%). During treatment the serum cholesterol rose in 64.7% of the children, 40.91% were constipated, 31.82% had periods of anorexia, symptomatic metabolic acidosis occurred during intercurrent infections in 9.09%, renal calculi in 9.09%, carnitine insufficiency in 9.09% and severe complications which led to hospital admission in 21.05%.

Our group of patients had no more side effects or complications than those described in the literature. KC may lead to complications, especially when strict guidelines for control and follow up are not used. However, they are usually easy to correct if detected early.