Pediatrics & Therapeutics
Open Access

Abstract

Ketogenic Diet For Refractory Epilepsy In Children- An Institutional Experience

Nélia Ferraria, Pedro Mendes, Fátima Oliveira, Cristina Martins, Maria José Fonseca and José Paulo Monteiro

Introduction: Ketogenic diet consists in a adequate protein diet (1 qram/kg), low in carbohydrates and rich in lipids, which induces a prolonged state of ketosis that modifies the cerebral energetic metabolism. This study aims to characterize the children with refractory epilepsy treated with ketogenic diet, enrolled in a Child Development Center in Portugal. It intends to evaluate the efficacy and tolerability of the diet and to identify in which epilepsy syndromes and etiologies the diet is effective. Methods: Retrospective analysis of the cases of refractory epilepsy treated with ketogenic diet. Results: Sixteen children were included, eleven boys. The mean age of seizures onset was 13,9 months (0-72 months) and of ketogenic diet onset was 4,4 years (5 months-16 years). At the end of the first month, 62,5% had a seizure reduction of more than 50%. The efficacy reached 43,8% at the end of third month and 31,3% at the end of the sixth month. In 31,3% there was a reduction of the number of anti-epileptic drugs and 56,3% had an improvement in the behavior/ cognition. The diet was more effective in infantile spasms, Lennox-Gastaut and Dravet syndromes and genetic and structural epilepsies, particularly in malformations of the cortical development. The mean time to a clinical response was 1,4 months. The diet had a good tolerability, with side effects only in 31,2%, none with clinical severity. Conclusion: In this study, ketogenic diet has proven to be safe and effective and should be considered in children with severe and refractory epilepsies.