Authors :
Presenting Author: Joo Hi Kim, MD – Department of Pediatric Neurology, Severance Children’s Hospital, Yonsei University College of Medicine
Ara Ko, MD – Department of Pediatric Neurology – Severance Children’s Hospital, Yonsei University College of Medicine; Eun Joo Lee, MD – Severance Children’s Hospital, Yonsei University College of Medicine; Se Hee Kim, MD – Department of Pediatric Neurology – Severance Children’s Hospital, Yonsei University College of Medicine; Joo Soo Lee, MD – Department of Pediatric Neurology – Severance Children’s Hospital, Yonsei University College of Medicine; Heung Dong Kim, MD – Department of Pediatric Neurology – Severance Children’s Hospital, Yonsei University College of Medicine; Hoon Chul Kang, MD – Department of Pediatric Neurology – Severance Children’s Hospital, Yonsei University College of Medicine
Rationale:
The ketogenic diet (KD) was previously not recommended for children under two years due to concerns about developmental impact and potential nutritional deficiencies. However, recent evidence, particularly focusing on infants with West syndrome, demonstrates the effectiveness and safety of the KD. Nonetheless, there is limited information on younger infants, especially those less than three months old. Therefore, this study aimed to share the experience of using the KD in such patients.
Methods:
A retrospective chart review was conducted including patients who started the KD before the age of three months at Severance Children’s Hospital between 2009 and 2020. Seizure control efficacy was assessed by collecting seizure frequency data from the previous month. Patients with a ≥ 50% reduction in seizures were considered responders, while non-responders included those who discontinued the KD due to poor compliance, adverse events, or the need for epilepsy surgery.
Results:
Out of 26 patients who started the KD before three months of age, 22 patients were included in the efficacy assessment after three months, with a response rate of 72.7%. After six months, 18 patients were assessed, and the response rate was 72.2%. When comparing clinical characteristics, Ohtahara syndrome showed a significant difference in response to the KD (p = 0.010), although this difference was not statistically significant when controlled for etiology. Adverse events leading to KD discontinuation were observed in three patients (11.5%) within six months, including hypoglycemia, aspiration pneumonia, and significant weight loss due to recurrent diarrhea.
Conclusions:
The ketogenic diet can be effectively and tolerably administered to young infants less than 3 months old.
Funding: This project was performed without any financial support.