Efficacy of the ketogenic diet as a therapy for intractable epilepsy in children

ABSTRACT

To determine the role of ketogenic diet in the treatment of intractable epilepsy in children. Sixty six consecutive children [1-16 years old] with intractable epilepsy whose seizure were not neurodegenerative nor febrile in origin were recruited. They received the ketogenic diet and we evaluated its effect on seizure frequency for 3 months. All these children had more than five seizures per week despite adequate therapy with at least 3-4 anticonvulsant medications. Carbohydrates were initially limited to 10 gr/day and fats constituted 75% of the total energy requirement. Response to the diet was categorized as free of seizure, 99%-75%, 50%-75%, 25%-49% and lower than 25% reduction [resistant to therapy]. Fifty five patients [84%] out of 66 children initiating the diet continued it after 1 week. After 3 months, 80% of the patients kept the diet. After one week, one month and 3 months, there was a more than 50% decrease in the frequency of the seizures in 40 [60%], 50 [75%] and 39 [59%] of the patients, respectively. Three patients [4.5%] were seizure-free after 1 week, 12 [18%] were seizure-free after one month and 12 [18%] were seizure-free after three months and a significant relationship was found between seizure reduction and the type of epilepsy [p<0.017]. The ketogenic diet should be considered as an alternative therapy for children with intractable seizures. It is more effective than many of the new anticonvulsant medications and is well tolerated by children and their families