Abstracts

RATIONALE: When multiple antiepileptic medications fail or produce undesirable side effects in treating intractable epilepsy, the ketogenic diet can be an effective treatment option. Through the review of this poster, participants will be able to discuss the results of one center[ssquote]s retrospective study regarding safety, efficacy, and tolerability of the ketogenic diet in children under 2 years of age.
METHODS: A retrospective medical record review was conducted of ketogenic diet patients who were under the age of 2 years when the diet was initiated, between August 1995 and March 2002. For each patient, seizure frequency and duration, antiepileptic medications, adverse effects, and parent comments were collected for the last clinic visit prior to diet initiation, the date of initiation, and the most recent clinical evaluation. The data collected before diet initiation was compared to the most recent clinical evaluation data and the results were assessed.
RESULTS: Seventeen children (9 boys and 8 girls) under the age of 2, with intractable epilepsy were placed on the ketogenic diet. Two were on the diet for less than one month, so they were excluded from the study. Of the fifteen children remaining, 6 (40%) became essentially seizure free, and an additional 8 (53.3%) had a greater than 50% reduction in seizure frequency compared to baseline. One child (6.7%) had no change in seizure frequency long term, but did have a significant reduction of antiepileptic medications. In all cases, there were concomitant reductions in antiepileptic medications. The majority of parents reported improvement in seizure frequency and duration, increased levels of alertness, activity, and improved cognitive function. There were no serious adverse effects such as kidney stones, hypoproteinemia, acidosis, hemolytic anemia or marked increases in liver function tests. Two children died as a result of other medical complications, but the ketogenic diet was not considered a factor.
CONCLUSIONS: The results demonstrate that children under 2 years of age had a reduction in seizure frequency without experiencing any adverse effects. Most children in this retrospective study were either tapered off all antiepileptic medications or had a significant reduction in the number of antiepileptic medications needed. Thus, the ketogenic diet should be considered a safe, effective and well-tolerated therapy for treating young children with intractable epilepsy.