Ketogenic Diet in Children with Primary Generalized Epilepsy at a Single Center
Abstract number :
3.205
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2023
Submission ID :
975
Source :
www.aesnet.org
Presentation date :
12/4/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Manan Nath, MBBS – Texas Children's Hospital | Baylor College of Medicine
Akshat Katyayan, MD – Texas Children's Hospital | Baylor College of Medicine; Gloria Diaz-Medina, MD – Texas Children's Medical Center | Baylor College of Medicine; Maureen Handoko-Yang, MD – Clinical Neurophysiology / Pediatric Epilepsy – Texas Children's Hospital | Baylor College of Medicine
Rationale: The ketogenic diet is a non-pharmacologic treatment in patients with drug-resistant epilepsy. There are few published reports on the use of ketogenic diet specifically in primary generalized epilepsy (Groomes et al., 2011; Kacker et al., 2022). We sought to evaluate whether Ketogenic Diet is effective in reducing seizures in patients with primary generalized epilepsy in our institution.
Methods: We conducted a retrospective chart review on patients seen at Texas Children’s Hospital epilepsy clinic who were treated with Ketogenic Diet for primary generalized epilepsy from January 2019 to December 2022. Clinical characteristics and electroencephalogram (EEG) reports were obtained from the electronic medical records and tabulated.
Results: We identified eight patients with primary generalized epilepsy who were treated with the ketogenic diet. Childhood absence epilepsy (CAE) was diagnosed in 4/8 (50%) patients, juvenile absence epilepsy in 1/8 (12.5%) patients, and juvenile myoclonic epilepsy (JME) in 3/8 (37.5%). Five patients were started on the Modified Atkins Diet and two patients were started on the Low Glycemic Index diet. Six out of eight patients discontinued the diet due to inability to adhere to the diet (5/6) or due to extended seizure freedom (1/6). Total duration of the ketogenic diet varied widely, with a median of 23 months (range 1- 42 months). At last clinic follow up while on the ketogenic diet, 4/8 (50%) reported seizure freedom when compliant with the diet (50%), 2/8 (25%) reported incomplete reduction in seizures, while 2/8 (25%) reported no improvement in seizures. Pre-diet interictal abnormalities comprised of generalized spike-wave activity occurring in isolation or brief bursts in 7/8 patients for which EEG reports were available. Of the five patients who received at least one follow up EEG while on the ketogenic diet, EEG had normalized in one patient.
Conclusions: The ketogenic diet is effective in reducing seizure frequency in our cohort of patients with primary generalized epilepsy. However, adherence to the ketogenic diet remains a significant barrier.
Funding: None
Clinical Epilepsy