Abstracts

The classical ketogenic diet(KD) was first used as a treatment for epilepsy in 1921. Current implementation and maintenance of the KD is specific for individual healthcare providers, particularly with regard to fasting and changes in medication in conjunction with the diet. Recent availability of the liquid formula is hypothesized to influence the use of the KD. The aims of this study were to determine the utilization and management of the liquid formulary versus the traditional KD A questionnaire was sent to child neurologists at 26 university hospitals in France. The questionnaire used a series of open or multiple-choice questions to collect data on the number of patients using the diet, the use of a fasting period, the energy intake, the efficacy criteria and the use of a liquid KD formula. In France, the liquid KD has been available since November 2002 . We asked for the total number of KD prescribed prior to and after the availability of the liquid KD formula Half of the child neurology departments/units replied (13/26). 85% of the responders prescribed KD. 46 % start the KD with a fasting period. 85 % provides 100% of the daily caloric requirement and 15 % use KD with caloric restriction. 38% decrease the daily amount of antiepileptic drugs. The efficacy of KD is evaluated after 1 month (median). 69 % consider KD as effective when the treatment permits a 50% decrease of the seizures. The availability of the liquid formula increased the use of KD. 2 centers prescribed 0 to 3 liquid KD before the commercial availability of the formula, as compared to 5 centers that prescribed 0 to 3 liquid KD and 2 centers that prescribed 4 to 7 liquid KD. With respect to both the liquid and traditional formularies, only 1 center prescribed 0 to 3 KD before the availability of the formula, whereas 4 centers prescribed 0 to 3 KD and 1 center prescribed 4 to 7 liquid KD after There is currently an international resurgence of interest in the ketogenic diet. The commercialization of the liquid KD seems to increase the prescriptions of KD in France for children with intractable epilepsy. Furthers studies on KD need to answer many issues about this treatment to maximize management and practice parameters. An international workshop would be useful to define both scientific and clinical guidelines
Acknowledgements to the responding centers