Benefits of Nonfasting Ketogenic Diet in Intractable Childhood Epilepsy as Compared with Initial Fasting Ketogenic Diet
Abstract number :
3.148
Submission category :
Year :
2001
Submission ID :
2826
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
H.D. Kim, MD, PhD, Dept. of Pediatrics, Inje University, Sang-gye Paik Hospital, Nowon Gu, Seoul, Korea; J.C. Park, MD, Dept. of Pediatrics, Inje University, Sang-gye Paik Hospital, Nowon Gu, Seoul, Korea
RATIONALE: Nonfasting ketogenic diet can be more easily introduced to intractable childhood epilepsy patients with less complications, same antiepileptic efficacy, and better tolerability, as compared with initial fasting ketogenic diet.
METHODS: We started ketogenic diet in 38 patients of intractable childhood epilepsy patients without initial periods of fasting with 1/3 required calories on the first day, 2/3 calories on the second day and full calories from the third days of ketogenic diet. Antiepileptic efficacy, duration until strong ketosis, days of hospitalization, number of acute dehydration, patient[ssquote]s tolerability and laboratory findings including BUN, electrolytes, LFT, lipid contents, and uric acid levels in patients with nonfasting ketogenic diet, were compared with those in 72 patients with initial fasting ketogenic diet.
RESULTS: 1. Fifteen(39.5%) patients became seizure free after nonfasting ketogenic diet, as compared with 29(40.2%) seizure free patients after initial fasting ketogenic diet until 3 months of follow-up.
2. Strong ketosis was obtained in 2.4[plusminus]1.2 days in non-fasting ketogenic diet as compared with 1.9[plusminus]1.3 days in initial fasting ketogenic diet.
3. Duration of hospitalization was shorter in nonfasting ketogenic diet than initial fasting ketogenic diet(mean 6.3 days vs. 8.6 days).
4. Moderate dehydration was more frequently compicated in initial fasting ketogenic diet (32.1%), than nonfasting ketogenic diet (21.1%) even maitenance of intravenous normal saline administration.
5. BUN was was more frequently elevated in initial fasting ketogenic diet, than nonfasting ketogenic diet.
6. There was no significant difference in other laboratory findings between 2 groups.
7. Nonfasting ketogenic diet was much better tolerable to intractable childhood epilepsy patients than initial fasting ketogenic diet.
CONCLUSIONS: Nonfasting ketogenic diet has same efficacy of antiepileptic activity, less complication such as acute dehydration, and better tolerability to patients than initial fasting ketogenic diet. Initial fasting is not necessary to every intractable childhood epilepsy patient for introduction of ketogenic diet.