Use of a gradual introduction of a ketogenic diet over 3 weeks for pediatric epilepsy in Mexico

Epilepsy is a common chronic neurological disorder. In childhood, approximately one-third of patients develop Drug-Resistant Epilepsy (DRE). A Ketogenic Diet (KD) is recommended for patients who do not respond to multiple antiseizure medications.

To evaluate the response of classical KD with a 3:1 ketogenic ratio on seizure control in pediatric patients diagnosed with DRE.

This was a retrospective cohort study. Data were collected from the clinical records of patients diagnosed with DRE who were treated with KD for three months between 2016 and 2022. The extracted variables included age, sex, anthropometric measurements, epilepsy type, seizure characteristics, pharmacological treatment, and adverse events at baseline, weeks 1 and 2, and months 1 and 3. Seizure reduction over time was assessed using a linear mixed-effects regression model.

Nineteen patients with DRE and treated with 3:1 KD were included. According to epilepsy type, 57.9 % of patients had epileptic syndrome and 26.3 % had generalized epilepsy. At baseline, the median number of seizures per day was 22 (IQR:10, 50). Seizure reduction was observed throughout the follow-up period, regardless of patient age and sex. The most significant decrease occurred in the first week after KD initiation (Δ -18.1; 95 % CI -29.7 to -6.6), with a continued decline at three months (Δ -31.1; 95 % CI -45.6 to -16.7). Forty-two percent of patients achieved seizure reduction at 1 week, 53.3 % at 2 weeks, 75 % at 1 month follow-up and 89.4 % at 3 months.

A 3:1 ketogenic diet showed good response in seizure reduction in children with DRE.