Decanoic acid-enriched ketogenic diet in refractory epilepsy

Area of Science:

• Neurology
• Metabolic Disorders
• Pediatric Epilepsy

Background:

• Refractory epilepsy in children poses significant treatment challenges.
• Ketogenic diets (KD) are established therapies for drug-resistant epilepsy.
• Medium-chain triglycerides (MCTs) are utilized in KD formulations.

Purpose of the Study:

• To compare the anti-seizure efficacy and safety of a C10-enriched MCT ketogenic diet (KD) versus a classic KD.
• To evaluate tolerability and adverse effects of both dietary interventions in pediatric patients.
• To explore the potential benefits of decanoic acid (C10) in ketogenic therapy.

Main Methods:

• A 16-week, open-label, randomized, controlled, crossover pilot study.
• Fifteen pediatric patients with refractory epilepsy were enrolled.
• Patients received both classic KD and C10-enriched KD for 8 weeks each.

Main Results:

• The C10-enriched KD achieved seizure reduction in all initial participants, with two becoming seizure-free.
• Patients switching to the C10-enriched KD demonstrated additional seizure reduction.
• Adverse effects were manageable, including transient hypoglycemia and gastrointestinal symptoms.

Conclusions:

• C10-enriched KD is a viable alternative for refractory epilepsy, comparable in efficacy and tolerability to classic KD.
• The diet shows potential for patients inadequately managed by standard ketogenic therapy.
• Decanoic acid may possess synergistic anti-seizure properties.