Clinical obsevr ation and follow-ups tudy of ketogenic diet adding treatment for epileptic spasms in chil-dren / 中国小儿急救医学

ABSTRACT

Objective To preliminarily study the efficacy and sfa ety of ketogenic diet( KD) adding treatment for epileptic spasm s in children.Methods The clinical features,efficacies,side effects and compli-ances of patients adding KD treatment in our hospital from July 2012 to December 2014 were analyzed. Results Totally 20 patients(10 months old to 8 years and 2 months old) of epileptic spasms with 14 boys and 6 girls were enrolled in the study.Among them 2 cases were less than 1 year old,10 cases were 1-3 years old,5 cases were 3-6 years old,and 3 casesw ere older thna 6 years.Twelve cases were cryptogenic epilepsy, 6 cases were symptomatic epilepsy(perian tal brain injury),1 case was brain malformation,and 1 case was severe viral encehp alitis sequela.Sp asm was the main episode of rm of all the cases.Amogn 20 caes s,7 cases were accompanied by some oteh r forms of episode, inlc uding secondarily generalized seizures, clonic seizures,tonic seizures,atypical absence seizures,and atypical absence status.The epileptic syndromes includ-ed infantile spasms or epileptic spasms(19 cases) and Lennox-Gastaut syndrome(1 case).The courses of disease were 11 days to 7 years and 9 months.One of them had severe liver function injury after oral antiepi-leptic medicine (11 days),and others were diagnosed intractable epilepsy.Overall,the KD dei t achieved the seizure-free state in 30%(6/20) of patients and a greater than 90% reduction of seizure frequency in one patient.In addition,12 patients got improvement in development of gross motor,while 6 of them had lingual developments.Severe side effects were not observed in follow-up studies.Eight cases com pleted the KD treat-ment for at least 6 months,12 cases stopped because of no efficacy,poor tolerance,diar hea and recrudesces. Conclusion KD adding treatment is probably an effective therapy for epileptic spasms with few side effects. While large samples and long-term observations are still desired to better recipes, and to provide possibly effective alternative to other therapies for epileptic spasms.