Abstracts

Rationale: Describe our experience with ketogenic diet (KD) on treatment of drug-resistant epilepsy in pediatric patients Methods: Description of eight pediatric patients with drug-resistant epilepsy on diverse clinical scenarios. Results: Eight patients are described, four female, average age of onset of epilepsy was 28.12 months (SD 17.27), and an average age of KD commencement of 62.25 months (SD 37.65). Within etiologies of epilepsy: three had a structural etiology, two with mitochondrial disease, one with Sandhoff disease and two indeterminate etiology. Average antiepileptic drugs prior KD were 5.4 and 3.6 afterwards. All patients had at least one episode of status epilepticus, on four, presented as super-refractory status epilepticus. The KD was given as a blenderized handmade formula created from pureed foods, except from one patient who received a formula-based KD. The fat to protein ratio was of 3:1 in three patients (37.5%) and of 4:1 in two of them (25%). The average time to reach urine ketones was 4.25 days.Five patients (62.5%) accomplished a 50% reduction in seizure frequency and a reduction above 90% on three (37.5%). Reported adverse effects were diarrhea, acidosis and vomiting; in one patient the KD discontinued due to lack of tolerance. Seven patients maintain KD; one patient with structural etiology underwent epilepsy surgery, three keep seizure control, one has seizures occasionally and two died from causes related to their underlying etiology. Conclusions: This case series presents several scenarios were KD was a useful, affordable, accessible and easy to administer therapy for seizure control. Randomized trials are needed to further analyze specific aspects of KD. Funding: No funding