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Evaluating the efficacy of a ketogenic diet in managing drug resistant paediatric DEDPC5-related epilepsy
Anna Winczewska-Wiktor1, Małgorzata Braszka2, Mia Harada-Laszlo2
1Department of Developmental Neurology, Poznan University of Medical Sciences, Poland.
Insights
The ketogenic diet (KD) effectively controlled seizures in most children with DEPDC5-related epilepsy. This epilepsy treatment also improved behavior and school performance with minimal side effects.
Area of Science:
- Epilepsy research
- Neurogenetics
- Dietary therapies
Background:
- Drug-resistant epilepsy presents significant challenges, particularly in pediatric cases.
- Mutations in the DEPDC5 gene are associated with specific epilepsy syndromes.
- Identifying effective treatment strategies for DEPDC5-related epilepsy is crucial.
Purpose of the Study:
- To assess the efficacy of the ketogenic diet (KD) in managing drug-resistant epilepsy in patients with DEPDC5 gene mutations.
- To evaluate the impact of KD on seizure control, neurological function, and behavioral outcomes.
- To determine the tolerability and safety of KD in this patient population.
Main Methods:
- A cohort of four pediatric patients with drug-resistant DEPDC5-related epilepsy was treated with a ketogenic diet.
- Clinical data, including seizure morphology, EEG, MRI, and neurological/psychological assessments, were analyzed pre- and post-treatment.
- The effectiveness of KD was compared to previous therapies, and its impact on comorbidities and adverse events was evaluated.
Main Results:
- Three out of four patients achieved seizure cessation with KD; one experienced reduced seizure severity after initial response.
- EEG results improved in all patients.
- Improvements in school performance and behavioral regulation were observed, with no significant adverse events.
Conclusions:
- The ketogenic diet is an effective and well-tolerated treatment for DEPDC5-related epilepsy in pediatric patients.
- KD can be used as monotherapy or as an adjunct to antiseizure medications (ASMs).
- Early implementation of KD is recommended for its benefits in seizure control and overall functioning.
Aim:
To evaluate the effectiveness of the ketogenic diet treatment in a cohort of patients with drug-resistant epilepsy with a mutation in the DEPDC5 gene.
Materials And Methods:
We followed four paediatric patients with drug resistant DEPDC5-related epilepsy through a ketogenic diet (KD) treatment course. We analyzed the following parameters of their clinical profiles: past medical history, clinical characteristics of seizure morphology, EEG records pre- and post-KD treatment, the results of MRI head and neurological and psychological examinations (pre-treatment and throughout treatment course). We evaluated the effectiveness of previous therapeutic approaches and the current treatment with ketogenic diet alongside results of neuroimaging studies. Effect of KD on co-morbid behavioural and psychiatric symptoms, as well as adverse effects from KD were also assessed.
Results:
In three patients, the introduction of the ketogenic diet resulted in the cessation of seizures, while in 1 patient with co-morbid cortical dysplasia, epileptic seizures of lesser severity returned after an initial seizure-free period of several weeks. Further, 1 patient was able to transition to a KD-only treatment regimen. The remaining patients were able to reduce the number of antiseizure medicine (ASM) to a monotherapy. In all cases we observed improvements in EEG results. Our cohort included one patient whose MRI head showed cortical dysplasia. However, no patients demonstrated any neurological signs in neurological examination. Psychological examination showed normal intellectual development in all patients, although behavioral disorders and difficulties at school were observed. The introduction of KD treatment correlated with improvement in school performance and improved behavioral regulation. No clinically significant adverse events were observed.
Conclusions:
KD seems to be both effective and well tolerated in young patients with DEPDC5-related epilepsy, both as a monotherapy and as an adjunct to ASM. We recommend an early adoption of this therapeutic approach in this patient demographic. Our results demonstrate that the positive effects of KD treatment encompass improvements in general functioning, particularly in the context of school performance and behavior, in addition to the achievement of good seizure control.
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