Add-on ketogenic diet versus antiseizure medications alone in children with developmental and epileptic...

Area of Science:

• Neurology
• Pediatric Epilepsy
• Dietary Therapies

Background:

• Developmental and epileptic encephalopathy (DEE) presents significant challenges in seizure management and developmental outcomes.
• Current treatment strategies, primarily involving antiseizure medications (ASMs) adjustment, often yield suboptimal results.

Purpose of the Study:

• To compare the effectiveness and safety of the ketogenic diet (KD) against adjustments in antiseizure medications (ASMs) for treating children with DEE.
• To evaluate seizure response, electroencephalography (EEG) improvements, developmental progress, and adverse events associated with KD versus ASMs adjustment.

Main Methods:

• A prospective, single-center cohort study involving 268 participants with DEE.
• Participants were allocated to either the KD group (n=128) or a control group receiving ASMs adjustment alone (n=140).
• Outcomes, including seizure response rates, EEG, and developmental progress, were assessed at 3 and 6 months.

Main Results:

• The KD group showed a significantly higher seizure response rate (50.78%) compared to the control group (29.29%) at 6 months.
• KD also led to superior seizure-free rates, greater EEG improvements, and better developmental progress.
• Adverse events were mild and acceptable, with a higher retention rate observed in the KD group.

Conclusions:

• The ketogenic diet (KD) demonstrates superior effectiveness and safety compared to ASMs adjustment in managing DEE in children.
• KD not only reduces seizure frequency and EEG abnormalities but also enhances developmental outcomes.
• These findings support the early consideration of KD as a therapeutic option for DEE management.