Abstracts

Rationale: To evaluate the effect of the ketogenic diet on electro-clinical characteristics and cognitive functions in children with continuous spikes and waves during slow sleep (CSWS). Methods: Five children (4 boys, 1 girl) aged between 8 and 13 years with CSWS refractory to conventional antiepileptic drugs (AEDs), steroids and levetiracetam were included. The prospective electro-clinical assessment was performed prior to the ketogenic diet and once every six months post initiation during the 2-year period. All children underwent neuropsychological testing prior to the ketogenic diet and again 12 and 24 months after the diet’s introduction. During the period on the ketogenic diet the concomitant AED treatment was unchanged. Results: Electrographical and neuropsychological evaluation after 24 months on the ketogenic diet showed CSWS resolution in one patient, mild decrease of the spike-wave index in one and lack of response in three patients. Ketogenic diet did not influence the neuropsychological outcome and IQ scores remained low at the end of the follow-up period. However, in two patients an improvement in attention and behavior was demonstrated. Conclusions: This is the first study evaluating the efficacy of the ketogenic diet in children with CSWS. Five presented cases were refractory to AEDs and steroids. Only one case responded with complete CSWS disappearance, in one the effect of the ketogenic diet was partial and intermittent, while in three patients no response has been observed. These results show that ketogenic diet does not have a significant influence on CSWS course. However, it should be confirmed in a larger series.