Authors :
Presenting Author: Khaled Al-Robaidi, MD – University of Alabama Medical Center
Monica McChesney, MS, RDN, LD – Children's of Alabama; Ismail Mohamed, MD – University of Alabama Medical Center
Rationale: The ketogenic diet is an established nonpharmacological treatment for refractory pediatric epilepsy, improving seizure burden and developmental outcomes. However, the long-term impacts remain unclear. This study assessed parental perception of seizure control and changes in seizure medication use during long-term ketogenic diet adherence.
Methods: A retrospective chart review was conducted of patients who were started and remained on the ketogenic diet for over two years at Children's of Alabama. Data were collected from ketogenic clinic visit notes, which were typically conducted at least twice yearly. The data collected included basic patient characteristics, duration of treatment, parental perception of seizure burden, number of anti-seizure medications, epilepsy surgical interventions, and other comorbidities. Statistical analysis was then performed using SPSS to compare groups of interest.
Results: The final sample included 32 patients with refractory epilepsy (mean age 9.83 ± 1.19) who were on the ketogenic diet for at least two years. The mean duration of treatment at the time of chart review was 7.18 ± 0.47 years, with 90% of patients electing to continue the diet. The most common causes of refractory epilepsy were genetic (37%), unknown (21%), and birth insults (19%). The mean number of anti-seizure medications prior to starting the ketogenic diet was 3.24 ± 0.22, and two years after starting the diet was 3.32 ± 0.16, with a P-value of 0.276. Around 78% of parents felt that there was an improvement in seizure burden around one month after starting the diet, compared to 53% around the two year mark (P-value = 0.035).
Conclusions:
This study found that in refractory epilepsies, remaining on a ketogenic diet for over two years did not significantly reduce the number of anti-seizure medications. In addition, there was a decrease in parental perception of improved seizure burden over time. Further research is needed to better understand the long-term effects of the ketogenic diet in this population.
Funding: None.