EFFICACY OF THE KETOGENIC DIET AS A THERAPY FOR INTRACTABLE EPILEPSY IN CHILDREN

ObjectiveTo determine the role of ketogenic diet in the treatment of intractableepilepsy in children.Materials & MethodsSixty six consecutive children (1-16 years old) with intractable epilepsywhose seizure were not neurodegenerative nor febrile in origin wererecruited. They received the ketogenic diet and we evaluated its effecton seizure frequency for 3 months. All these children had more than fiveseizures per week despite adequate therapy with at least 3-4 anticonvulsantmedications. Carbohydrates were initially limited to 10 gr/day and fatsconstituted 75% of the total energy requirement. Response to the dietwas categorized as free of seizure, 99%-75%, 50%-75%, 25%-49% andlower than 25% reduction (resistant to therapy).ResultsFifty five patients (84%) out of 66 children initiating the diet continued itafter 1 week. After 3 months, 80% of the patients kept the diet. After oneweek, one month and 3 months, there was a more than 50% decreasein the frequency of the seizures in 40 (60%), 50 (75%) and 39 (59%) ofthe patients, respectively. Three patients (4.5%) were seizure-free after1 week, 12 (18%) were seizure-free after one month and 12 (18%) wereseizure-free after three months and a significant relationship was foundbetween seizure reduction and the type of epilepsy (p<0.017).ConclusionThe ketogenic diet should be considered as an alternative therapy forchildren with intractable seizures. It is more effective than many of thenew anticonvulsant medications and is well tolerated by children andtheir families.