[The ketogenic diet in infantile refractory epilepsy: electroclinical response, complications and secondary effects]. / Dieta cetogénica en la epilepsia refractaria infantil: respuesta electroclínica, complicaciones y efectos secundarios.

INTRODUCTION: The ketogenic diet (KD) was developed after observation that prolonged starvation might lead to the seizures stopping. Due to is efficacy and safety, KD plays an important part in the management of children with refractory epilepsy. OBJECTIVES: To show the clinical anticonvulsant response of KD, the electroencephalographic changes, the need for strict methodology to enhance the success of the treatment, and evaluation of the side effects and complications observed. PATIENTS AND METHODS: After being started on a protocol of a classical ketogenic diet, 13 patients aged between 1 and 19 years were prospectively evaluated for an average period of 22 months. All had different types of refractory epilepsy according to Schmidt's scores, as modified by Aicardi. RESULTS: There was over 50% reduction in the number of crises of 84.5% of the children. Complete control was attained in 30.8%. The electroencephalographic recordings showed improvement in 100% of the children. The families involved reported a 58.8% reduction in the side effects observed. During treatment the serum cholesterol rose in 72.7% of the children, 36.4% complained of constipation, 27.3% had a brief period of anorexia and there was symptomatic metabolic acidosis during intercurrent infection and renal lithiasis in one patient. CONCLUSION: The clinical and electroencephalographic improvement and minimal side-effects seen confirm that KD is beneficial in refractory epilepsy in children.

[The electroencephalographic evolution of a group of patients on a ketonic diet]. / Evolución electroencefalográfica de un grupo de pacientes en dieta cetogénica.

INTRODUCTION: A ketogenic diet is an old method for the treatment of resistant epilepsy in children, which has been revived in recent years because of its proven efficacy. OBJECTIVE: To correlate electroencephalographic findings and clinical changes observed in a group of patients on the classical ketogenic diet, to determine the validity of the electroencephalogram in following-up treatment. PATIENTS AND METHODS: We made a prospective evaluation of 11 patients aged between 1 and 19 years for an average period of 22 months. The patients had different types of resistant epilepsy according to Schmidt's score as modified by Aicardi, with a sleep encephalogram prior to treatment and 3, 6, 12 and 24 months later, after following the protocol of the classical ketogenic diet. RESULTS: The sleep encephalograph recordings showed changes in all patients. In 9% of cases they became normal, there was great improvement in 45.45% and some improvement in 45.45%. No patient had worsening of the recording. There was over 50% reduction in the number of seizures seen in 72.7% of the children and complete control was achieved in 27.3%. CONCLUSIONS: Normalization or improvement of sleep encephalogram recordings was correlated with improvement in seizures. Electroenchephalogram follow-up is a useful method for prediction of response to treatment with a ketogenic diet.