Ketogenic diet therapy in infants less than two years of age for medically refractory epilepsy

Area of Science:

• Pediatric Neurology
• Metabolic Therapies
• Epileptology

Background:

• The Ketogenic Diet (KD) is a recognized treatment for epilepsy in children and adults.
• Medically refractory epilepsy in infants presents significant management challenges.

Purpose of the Study:

• To evaluate the 10-year experience of using the Ketogenic Diet (KD) in infants under two years old with medically refractory epilepsy.
• To assess the efficacy and tolerability of KD in this specific pediatric population.

Main Methods:

• A retrospective case-note review was conducted.
• Infants diagnosed with epilepsy and managed with KD between 2006 and 2016 were included.
• Data on seizure control, drug use, and adverse effects were analyzed.

Main Results:

• Twenty-nine infants (2.5 weeks to 23 months) with various epilepsy types were studied.
• Most infants had daily seizures and were on multiple anti-epilepsy drugs (AEDs) prior to KD.
• Approximately 50% of infants showed seizure reduction (freedom, >50% reduction, or decreased intensity/frequency).
• KD was well-tolerated, with only two discontinuations due to poor tolerability; 45% experienced no adverse effects.

Conclusions:

• The Ketogenic Diet (KD) is a viable and generally well-tolerated treatment option for severe epilepsies in infants.
• KD demonstrated efficacy in improving seizure frequency and/or severity in about half of the studied infants.
• The study suggests no adverse impact on developmental outcomes with KD in this age group.