One Center's Experience With Outpatient Initiation of Ketogenic Therapy in Infants 18 Months or Younger

Area of Science:

• Pediatric Neurology
• Metabolic Therapies
• Epilepsy Management

Background:

• Ketogenic therapy is a standard adjunctive treatment for drug-resistant epilepsy.
• Traditional initiation of ketogenic therapy requires hospitalization for patients.
• Infants aged 18 months and younger present unique challenges for epilepsy treatment.

Purpose of the Study:

• To evaluate the safety and efficacy of outpatient initiation of ketogenic therapy.
• To assess the feasibility of this approach in infants 18 months and younger.
• To compare outcomes with traditional inpatient initiation protocols.

Main Methods:

• A retrospective chart review was conducted on 37 infants.
• Patients initiated ketogenic therapy between 2011 and 2022 were included.
• Data on seizure reduction and adverse effects were analyzed.

Main Results:

• Ketogenic therapy reduced seizures by at least 50% in 62% of infants.
• Adverse effects, including constipation, vomiting, and acidosis, occurred in 86% of patients.
• All adverse effects were managed outpatient, with only 12% requiring hospitalization.

Conclusions:

• Outpatient initiation of ketogenic therapy is a safe and effective strategy for infants up to 18 months.
• This approach demonstrates successful seizure control with manageable adverse events.
• The findings support a shift towards outpatient protocols for this patient population.