Abstracts

RATIONALE: To elicit the clinical and electrophysiological characteristics of intractable childhood epilepsy, who can be successfully treated by ketogenic diet. METHODS: We analyzed clinical and EEG findings of intractable childhood epilepsy patients, who were successfully treated by ketogenic diet with showing seizure free duration for more than 6 months, as compared with patients, who were not successfully treated. Among 92 medically intractable epileptic patients, 39 patients (42.4%) showed complete seizure remission more than 6 months. Among 39 patients, 7 patients relapsed during or after discontinuation of ketogenic diet. We studied the effecacy of ketogenic diet according to clinical seizure type, age, etiologic factors, neurological features, and EEG characteristics. RESULTS: 1)Complete seizure remission over 6 months were obtained in 15 patients of infantile spasm (IS), 6 cases of Lennox-Gastaut syndrome (LGS), 4 cases of periodic spasm, 3 cases of severe myoclonic epilepsy in infance (SMEI), 1 case of Landau-Kleffner syndrome, 8 cases of other types of partial epilepsies, and 2 patients of other generalized epilepsies. 2) Ketogenic diet was more effective in infantile spasm than other types of epilepsy. 3) Ketogenic diet was least effective in Lennox-Gastaut syndrome. 4) In same types of epilepsies, ketogenic diet was more effective in patients with less frequent seizures, and less severe EEG findings. 5) Complete remission was better developed in patients, whose seizure was stoppped earlier. 6) Age, etiological factors, neurological deficit were not related to efficacy of ketogenic diet. 7) Most patients were tolerable to ketogenic diet without major complications. CONCLUSIONS:_Ketogenic diet was most effective in infantile spasm, patients with less frequent seizures in same type of epilepsy, less severe EEG findings in same seizure type, and patients whose seizures stopped sooner after administration of ketogenic diet.