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Ketogenic diet in the treatment of refractory continuous spikes and waves during slow sleep

Marina Nikanorova1, Maria J Miranda, Mary Atkins

  • 1Childrens Department, Danish Epilepsy Centre, Dianalund, Denmark. mnk@filadelfia.dk

Epilepsia
|February 18, 2009
PubMed

Insights

The ketogenic diet showed limited efficacy in children with continuous spikes and waves during slow sleep (CSWS), with only one patient achieving complete resolution. Cognitive function and IQ scores were not significantly impacted by the diet.

Area of Science:

  • Pediatric Neurology
  • Neuroscience
  • Dietary Therapies

Background:

  • Continuous spikes and waves during slow sleep (CSWS) is a severe epilepsy syndrome in children.
  • CSWS is often refractory to conventional antiepileptic drugs (AEDs) and steroids.
  • The ketogenic diet is an established therapy for some pediatric epilepsy syndromes.

Purpose of the Study:

  • To assess the impact of the ketogenic diet on electroclinical features of CSWS in children.
  • To evaluate the effect of the ketogenic diet on cognitive function in pediatric CSWS patients.
  • To determine the efficacy of the ketogenic diet in drug-refractory CSWS cases.

Main Methods:

  • A prospective study of five children (8-13 years) with refractory CSWS.
  • Electroclinical assessments were conducted pre-diet and every 6 months for 2 years.
  • Neuropsychological testing was performed pre-diet and at 12 and 24 months post-initiation.

Main Results:

  • CSWS resolution occurred in one of five patients after 24 months.
  • Three patients showed no response, and one had a partial, intermittent response.
  • The ketogenic diet did not significantly alter overall cognitive function or IQ scores, though attention and behavior improved in two patients.

Conclusions:

  • The ketogenic diet demonstrated limited efficacy in this small cohort of children with refractory CSWS.
  • While one patient experienced complete electroclinical remission, the diet did not consistently resolve CSWS or improve cognitive outcomes.
  • Further research with a control group is needed to definitively establish the ketogenic diet's role in managing CSWS.
Abstract

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