Ketogenic diet use in children with intractable epilepsy secondary to malformations of cortical development: A two-...

Area of Science:

• Neurology
• Pediatric Neurology
• Epileptology

Background:

• Drug-resistant epilepsy is a significant challenge in pediatric patients.
• Malformations of cortical development are a common cause of refractory epilepsy in children.
• The ketogenic diet (KD) is an established alternative therapy for epilepsy.

Purpose of the Study:

• To assess the efficacy and tolerability of the ketogenic diet (KD) for treating drug-resistant epilepsy.
• To investigate KD's effectiveness in pediatric patients with epilepsy secondary to malformations of cortical development.
• To compare KD response rates across different types of cortical malformations.

Main Methods:

• A retrospective analysis of 45 pediatric patients with refractory epilepsy due to cortical malformations was conducted.
• Patients were categorized into three groups based on the type of malformation: abnormal neural proliferation, migration, or post-migrational development.
• Efficacy was measured by seizure frequency reduction, specifically identifying patients with >50% reduction.

Main Results:

• Twenty patients (44%) achieved over 50% seizure frequency reduction, with two becoming seizure-free.
• The ketogenic diet adherence varied, with treatment durations ranging from 4 to 96 months.
• Patients with abnormal post-migrational development (Group 3) showed the highest response rate (64.7%) compared to other groups.

Conclusions:

• The ketogenic diet is a viable treatment option for drug-resistant epilepsy in pediatric patients with cortical malformations.
• Patients with post-migrational developmental abnormalities demonstrated the most significant seizure reduction with KD.
• KD should be considered when surgical interventions are not feasible for this patient population.