Abstracts

Rationale: The objective of this study is to determine the efficacy of the ketogenic diet in controlling infantile spasms after failing traditional anti-epileptic medication therapy Methods: A retrospective chart review study of 8 patients with infantile spasms age 3 months to 3 years; 6 females and 2 males. Six patients had symptomatic infantile spasms, and the remaining two had cryptogenic infantile spasms. All patients continued to have infantile spasms with evidence of hypsarrhythmia on their electroencephalograms (EEGs) despite treatment with ACTH and/or vigabatrin. Patients were started on the ketogenic diet. Time intervals until cessation of infantile spasms, as well as resolution of hypsarrhytmia were studied using parent reports and EEGs when available. Also the incidence of side effects from the ketogenic diet was monitored. Quality of life improvement was charted based on the care giver s perspective. Results: All eight patients included in this study failed to respond to ACTH and/or vigabatrin before going on the ketogenic diet. Seven patients (88%) achieved cessation of infantile spasms within 4-10 weeks (mean 6 weeks) after starting the ketogenic diet. Four of these seven patients had follow up EEGs within 4-8 weeks of starting the diet showing recovery of the hypsarrythmia pattern. One patient did not have any improvement and had to quit the diet after 6 months due to excessive vomiting. At the 3 months visit, care givers of 7 of the 8 patients reported overall improvement of quality of life. Conclusions: The ketogenic diet is a safe and potentially effective method of treatment for patients with infantile spasms; especially those who did not respond to customary medication therapies. The low incidence of side effects, as well as the reported significant improvement of quality of life makes it very encouraging to use the ketogenic diet in pharmacologically resistant infantile spasms patients. This would also encourage a prospective randomized study, studying the use of Ketogenic diet versus ACTH, or Vigabatrin as a first line treatment for infantile spasms