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Ketogenic diet effects on 52 children with pharmacoresistant epileptic encephalopathy: A clinical prospective study
Qiong Wu1, Hua Wang1, Yu Ying Fan1
1Department of Pediatric Neurology Shengjing Hospital of China Medical University Shenyang China.
Insights
The ketogenic diet (KD) shows clinical impact in children with drug-resistant epileptic encephalopathy, improving seizure control and cognitive function with manageable side effects.
Area of Science:
- Pediatric Neurology
- Metabolic Therapies
- Epilepsy Research
Background:
- Pharmacoresistant epileptic encephalopathy poses significant challenges in pediatric care.
- Limited treatment options exist for severe, refractory epilepsy syndromes in children.
Purpose of the Study:
- To evaluate the clinical effectiveness of the ketogenic diet (KD) in children diagnosed with pharmacoresistant epileptic encephalopathy.
- To analyze the impact of KD on seizure frequency, electroencephalogram (EEG) findings, cognitive function, and adverse reactions.
Main Methods:
- A cohort of 52 children with pharmacoresistant epileptic encephalopathy (including West, Lennox-Gastaut, Doose, and Dravet syndromes) were treated with KD.
- The Modified Johns Hopkins protocol was used for KD initiation.
- Seizure control was assessed using the Engel scale, alongside analysis of EEG, cognitive, language, and motor function.
Main Results:
- At 12 weeks, 26.9% of patients showed Grade I seizure control, with overall efficacy varying by syndrome (100% for Doose, 57.9% for West).
- A reduction in epileptiform discharges correlated with decreased seizure frequency.
- Improvements were observed in cognitive function (23 patients), language (12 patients), and motor function (10 patients).
Conclusions:
- The ketogenic diet demonstrates efficacy in managing pharmacoresistant epileptic encephalopathy in children.
- KD can reduce interictal epileptic discharge frequency and improve EEG background rhythm.
- The diet offers a viable clinical option with tolerable side effects, improving neurological functions.
Objective:
To evaluate the clinical impact of ketogenic diet (KD) on children with pharmacoresistant epileptic encephalopathy.
Methods:
In all, 52 children with pharmacoresistant epileptic encephalopathy that diagnosed in our hospital from July 2012 to June 2015 were selected, including West syndrome 38 cases, Lennox-Gastaut Syndrome 7 cases, Doose Syndrome 1 case, and Dravet syndrome 6 cases, and the effect, compliance, adverse reactions, electroencephalogram (EEG), and cognitive function were analyzed. Modified Johns Hopkins protocol was used to initiate KD, and Engel scale was used to evaluate the effect, and evaluated the effect of KD on the cognition, language, and motor function.
Results:
At 12 weeks of KD treatment, the patients achieved I, II, III, and IV grade effect were accounted for 26.9% (14/52 cases), 17.3% (9/52 cases), 11.5% (6/52 cases), and 44.2% (23/52 cases), respectively, according to Engel scale. KD has different effect on different epileptic syndromes, best effect on Doose syndromes of 100%, and better effect on West syndrome with the effect rate of 57.9%, and the total effect number was 22 cases. The reduction of epileptiform discharges in the awake state before KD treatment was correlated with the seizure time after 3 months of KD treatment (r = .330, p = .017). The cognitive function of 23 patients was improved, 12 patients had language improvement, and the motor function was improved in 10 patients. In all, 23 patients had adverse reactions, and all patients were tolerated and improved.
Conclusion:
KD has certain effect on children with pharmacoresistant epileptic encephalopathy, and it can reduce interictal epileptic discharge frequency, and improve the background rhythm of EEG. The reduction of epileptiform discharges in awake state is in favor of the reduction of seizures frequency, thus increasing the efficacy, and improve the cognitive function, language, and motor function to varying degrees, combined with less adverse reaction, which is worthy of clinical application.
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