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Updated: Jun 7, 2025
Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients
Published on: December 18, 2016
Effectiveness and safety analysis of ketogenic diet therapy for drug-resistant epilepsy caused by structural
Hongwei Zhang1,2,3,4, Song Su3,4, Huan Zhang3,4
1Department of Neurology, Children's Hospital Affiliated to Shandong University, Jinan, Shandong, China.
Insights
The ketogenic diet (KD) is effective for treating drug-resistant epilepsy in children with structural causes, also improving cognitive and behavioral symptoms. Efficacy is greatest in malformations of cortical development (MCD), especially focal cortical dysplasia (FCD).
Area of Science:
- Pediatric Neurology
- Dietary Therapies
Background:
- Drug-resistant epilepsy (DRE) in children with structural etiologies presents significant management challenges.
- The ketogenic diet (KD) is a well-established therapy for epilepsy, but its efficacy in structurally-defined DRE requires further elucidation.
Purpose of the Study:
- To evaluate the safety and effectiveness of the ketogenic diet (KD) in pediatric patients with drug-resistant epilepsy (DRE) stemming from structural brain abnormalities.
- To compare KD efficacy between different structural etiologies and assess associated cognitive and behavioral outcomes.
Main Methods:
- Children with DRE due to structural etiology were divided into acquired brain injury and malformations of cortical development (MCD) groups.
- Seizure frequency, adverse events, and reasons for discontinuation were monitored at 1, 3, and 6 months post-initiation of KD.
- Cognitive and behavioral improvements were assessed, and statistical analyses were performed.
Main Results:
- Seizure-free rates were 4.8%, 19%, and 21.4% at 1, 3, and 6 months, respectively.
- Overall seizure control rates were 42.9%, 52.4%, and 54.8% at the same time points.
- The MCD group demonstrated higher seizure control than the acquired brain injury group, with focal cortical dysplasia (FCD) showing the highest efficacy. Cognitive and behavioral improvements were noted in 69% of patients by 3 months. Lack of efficacy and poor compliance were primary reasons for discontinuation.
Conclusions:
- The ketogenic diet (KD) is a safe and effective therapeutic option for pediatric drug-resistant epilepsy (DRE) with structural etiologies.
- KD offers additional benefits, including improvements in cognitive and behavioral function.
- Higher efficacy was observed in the malformations of cortical development (MCD) group, particularly in focal cortical dysplasia (FCD), supporting early consideration of KD for these patients.
Objective:
To explore the effectiveness and safety of the ketogenic diet (KD) in children with drug resistant epilepsy (DRE) caused by structural etiology.
Methods:
The children were categorized into acquired brain injury group and malformations of cortical development (MCD) group based on the etiology. Follow-up assessments were performed at 1, 3, and 6 months after KD treatment to observe seizure reduction, behavioral and cognitive improvements, adverse reactions events, and reasons for discontinuation withdrawal. Statistical analysis was conducted on the results.
Results:
We found the seizure-free rates at 1, 3, and 6 months were 4.8% (2/42), 19% (8/42), and 21.4% (9/42), respectively. The seizure control effective rates were 42.9% (18/42), 52.4% (22/42), and 54.8% (23/42) at the corresponding time points. Compared to the acquired brain injury group, the MCD group showed a higher seizure control effective rate. Further analysis within the MCD group revealed the highest efficacy in focal cortical dysplasia (FCD). At the 3-month follow-up, cognitive and behavioral improvements were observed in 69% (29/42) of children. The main reasons for discontinuation were lack of efficacy and poor compliance.
Significance:
Finally, we get that KD is a safe and effective treatment for drug resistant epilepsy caused by structural etiology, with the added benefit of improving behavioral and cognitive abilities in children. The efficacy is higher in children with MCD, particularly in cases of FCD. Early intervention with KD is recommended for this population.
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