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Ketogenic Diet for the Management of Epilepsy Associated with Tuberous Sclerosis Complex in Children
Soyoung Park1, Eun Joo Lee2, Soyong Eom3
1Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
Insights
The ketogenic diet (KD) effectively manages intractable epilepsy in children with tuberous sclerosis complex (TSC), showing significant seizure reduction and potential cognitive benefits.
Area of Science:
- Neurology
- Pediatrics
- Metabolic Disorders
Background:
- Tuberous sclerosis complex (TSC) is a genetic disorder associated with intractable epilepsy.
- Epilepsy in TSC often requires multiple antiepileptic drugs.
- Non-pharmacological interventions are crucial for managing refractory epilepsy in TSC.
Purpose of the Study:
- To evaluate the efficacy of the ketogenic diet (KD) for epilepsy management in children with TSC.
- To assess seizure reduction and qualitative improvements in cognition and behavior.
- To determine the long-term outcomes of KD therapy in this patient population.
Main Methods:
- Retrospective enrollment of 12 children with TSC and intractable epilepsy.
- Treatment with KD between March 2008 and February 2015.
- Analysis of seizure frequency, cognitive/behavioral changes, and treatment duration.
Main Results:
- 83.3% of patients achieved >50% seizure reduction at 3 months.
- 58.3% showed qualitative improvements in cognition and behavior.
- Mean duration of KD therapy was 14.8 months; 50% eventually underwent epilepsy surgery.
Conclusions:
- The ketogenic diet is a valuable non-pharmacological treatment for intractable epilepsy in TSC.
- KD offers potential benefits beyond seizure reduction, including improved cognition and behavior.
- Further research is warranted to optimize KD strategies for TSC-associated epilepsy.
Background And Purpose:
In the present study, we reviewed the outcome of ketogenic diet (KD) use for the management of epilepsy in children with tuberous sclerosis complex (TSC).
Methods:
A total of 12 children with intractable epilepsy associated with TSC who were treated with KD at our hospital between March 1, 2008 and February 28, 2015 were retrospectively enrolled.
Results:
The mean age at the time of KD initiation was 73.1 ± 38.0 months. Patients were medically refractory to a mean of 4.8 ± 1.7 antiepileptic drugs. Nine patients (75.0%) had a history of infantile spasms. At 3 months after KD initiation, 10 patients (83.3%) had > 50% seizure reduction. Moreover, 7 patients (58.3%) exhibited qualitative improvements in cognition and behavior after KD initiation, as reported by caregivers/parents. The mean duration of dietary therapy was 14.8 ± 12.8 months. Half of the patients in this study eventually underwent epilepsy surgery due to persistent seizures or seizure relapse.
Conclusion:
KD is an important non-pharmacological treatment option for patients with intractable epilepsy associated with TSC. KD may improve cognition and behavior in addition to reducing seizure frequency.
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