Use of the ketogenic diet in the neonatal intensive care unit-Safety and tolerability

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Lindsey Thompson1, Erin Fecske2, Mohammad Salim2

  • 1Nutrition, Children's Mercy Hospital, Kansas City, Missouri, U.S.A.

Epilepsia
|January 13, 2017
PubMed

Insights

The ketogenic diet can be safely used in neonatal intensive care units (NICUs) for drug-resistant epilepsy. This diet showed benefits including improved seizure control and alertness in infants.

Area of Science:

  • Neonatal Medicine
  • Neurology
  • Nutritional Science

Background:

  • Drug-resistant epilepsy is a significant challenge in neonatal patients, particularly those with comorbidities in the NICU.
  • Existing treatments may be limited for refractory epilepsy in neonates.

Purpose of the Study:

  • To evaluate the safety and tolerability of the ketogenic diet in neonates with drug-resistant epilepsy within the NICU setting.
  • To assess the efficacy of the ketogenic diet in improving seizure control and other clinical outcomes in this population.

Main Methods:

  • Retrospective analysis of four infants with drug-resistant epilepsy who received a ketogenic diet in the NICU.
  • Nonfasting induction of ketosis over 1-2 weeks with gradual increases in ketogenic ratio.
  • Data collection included medical history, progress notes, laboratory results, and diagnostic information.

Main Results:

  • The ketogenic diet was well tolerated in all four cases.
  • Common side effects included constipation, hypoglycemia, and weight loss.
  • Serum β-hydroxybutyrate proved more reliable than urine ketones for monitoring ketosis. Improved seizure control, alertness, and reduced need for respiratory support were observed.

Conclusions:

  • The ketogenic diet can be safely implemented and is well tolerated in carefully selected neonates and infants within the NICU for refractory epilepsy.
  • This dietary intervention shows promise for improving seizure control and clinical outcomes in neonatal encephalopathy and refractory epilepsy.

Keywords:
Diet therapiesNeonatal intensive care unitNonpharmacologicRefractory epilepsy

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