Changes in growth and seizure reduction in children on the ketogenic diet as a treatment for intractable epilepsy
Sarah J Peterson1, Christy C Tangney, Erika M Pimentel-Zablah
1Department of Clinical Nutrition, Rush University Medical Center #425, 1700 West Van Buren, Chicago, IL 60612, USA. Sarah_J_Peterson@rush.edu
Insights
The ketogenic diet, used for intractable epilepsy, may delay growth in children. Further research is needed to understand the link between ketosis and growth in these patients.
Area of Science:
- Pediatric Neurology
- Metabolic Disorders
Background:
- Intractable epilepsy in children often requires alternative treatments.
- The ketogenic diet is a recognized therapy for drug-resistant epilepsy.
- Growth and seizure control are key outcomes to monitor during ketogenic diet therapy.
Purpose of the Study:
- To evaluate the impact of the ketogenic diet on growth parameters in epileptic children.
- To assess the efficacy of the ketogenic diet in reducing seizures.
- To explore the relationship between ketosis levels, growth, and seizure reduction.
Main Methods:
- Retrospective chart review of 57 children (ages 1-26) on the ketogenic diet.
- Data collection included urinary ketone levels, height/weight z-scores, and seizure frequency at baseline, 6, and 12 months.
- Statistical analyses included Mann-Whitney U, Friedman, Wilcoxon sign rank, and chi-squared tests, plus logistic regression.
Main Results:
- Height-for-age z-scores significantly decreased after 12 months on the diet (P <= .0005).
- Subjects with high ketosis showed a significant decrease in height-for-age z-scores (P <= .0005).
- Seizure reduction rates were comparable to other published studies.
Conclusions:
- The ketogenic diet was associated with a delay in growth in pediatric epilepsy patients.
- A significant relationship exists between ketosis levels and growth impairment.
- Further investigation is warranted to elucidate the ketosis-growth relationship in this population.
Objective:
To assess growth and seizure reduction in epileptic children using the ketogenic diet as a treatment for intractable epilepsy.
Design:
A retrospective chart review was designed to evaluate urinary ketone levels, height and weight z scores and percentiles, and seizure reduction. Data were collected at baseline and at 6 and 12 months.
Subjects/Settings:
Fifty-seven subjects, ages 1 to 26 years old, started the ketogenic diet at Rush University Medical Center between August 1995 and December 2001. Thirty-nine subjects stayed on the diet for 6 months, and five more were lost by the 12th month of follow-up. Statistical analysis Mann-Whitney U tests assessed differences between male and female subjects and between subjects with high ketosis and moderate ketosis. Friedman tests followed by Wilcoxon sign rank tests assessed the significance of changes in growth at baseline and at 6 and 12 months. Associations between seizure reduction and growth and urinary ketone levels were determined using chi 2 tests. A binary logistic regression model identified potential predictors of growth and seizure reduction.
Results:
Height-for-age z scores significantly decreased ( P < or =.0005) from -0.30+/-1.19 to -0.99+/-1.13 among subjects on the diet for 12 months. Subjects with high ketosis (80 to 160 mg/dL) experienced a significant decrease ( P < or =.0005) in height-for-age z scores from -0.45+/-1.28 to -1.1+/-1.23, whereas subjects with moderate ketosis did not. Observed percent seizure reduction was similar to those of other published studies.
Conclusions:
Subjects on the ketogenic diet showed a delay in growth. More research is needed to evaluate the relationship between ketosis and growth.
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:20Seizures l: Introduction
01:13Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
01:22Epilepsy ll: Types
01:30Electroconvulsive Therapy