The ketogenic diet improves recently worsened focal epilepsy
Version of Record online: 3 FEB 2009
© The Authors. Journal compilation © Mac Keith Press 2008
Developmental Medicine & Child Neurology
Volume 51, Issue 4, pages 276–281, April 2009
How to Cite
VILLENEUVE, N., PINTON, F., BAHI-BUISSON, N., DULAC, O., CHIRON, C. and NABBOUT, R. (2009), The ketogenic diet improves recently worsened focal epilepsy. Developmental Medicine & Child Neurology, 51: 276–281. doi: 10.1111/j.1469-8749.2008.03216.x
- Issue online: 18 MAR 2009
- Version of Record online: 3 FEB 2009
- PUBLICATION DATA Accepted for publication on 15th October 2008. Published online 3rd February 2009.
Aim We observed a dramatic response to the ketogenic diet in several patients with highly refractory epilepsy whose seizure frequency had recently worsened. This study aimed to identify whether this characteristic was a useful indication for the ketogenic diet.
Method From the 70 patients who received the ketogenic diet during a 3-year period at our institution, we retrospectively selected patients with focal epilepsy. There were 22 children, 13 females and nine males, aged from 5 months to 18 years 6 months (mean 6y 9mo, SD 5y 11mo). Fifteen had symptomatic and seven had cryptogenic focal epilepsy. Seizure frequency 1 week before initiating the ketogenic diet was compared with that at 1 month and at the last visit on the diet.
Results Eleven patients were responders (defined as reduction of seizures by more than 50%) at 1 month. Responders were higher (p=0.046) in the group with a recent worsening of seizures than in those with stable seizure frequency. Seven patients were still seizure-free at 6 months on the diet. Tolerability was excellent in 10 patients. Five patients stopped the diet because of early side effects.
Interpretation The ketogenic diet may be a valuable therapeutic option for children with pharmacoresistant focal epilepsy, particularly those with a recent deterioration of seizure control and neurological status. Because of its rapid effect, the ketogenic diet may be a useful support to intravenous emergency drugs in such a situation.