Abstracts

Rationale: The ketogenic diet (KGD) has proven to be an effective method in treating pharmacologically intractable epilepsy. This study, aims to assess ketogenic diet efficacy, tolerability and quality of life improvement according to families' reports in infants. Having such data will help address the efficacy of the ketogenic diet amongst this special population. This data will also assist in anticipating potential complications that can occur with in this age group.Methods: We conducted a retrospective chart review of all infant patients who received ketogenic diet therapy from May 2005 through May 2011 in the pediatric neurology program at Children s Mercy Hospital.(N= 15) Patient age 5 Days 1yr; 9 male,6 female. Average age of epilepsy onset 2.5mos Data was collected on epilepsy type, seizure control, laboratory values including CO2 level, glucose levels, betahydroxybuterate levels, during induction, 1month, 3months and 6months. Analyzing the data to determine tolerability, efficacy and feasibility of the ketogenic diet amongst this special populationResults: At one month follow up, 15 patients were on a ketogenic diet. At 3 months 10 patients, at 6 months, 8 patients were still on a ketogenic diet. After one month,11 of patients had greater than 50 percent seizure reduction, 3 had less than 50% seizure reduction, and 1 had no seizure improvement. At 3 months, 2 had greater than 50% seizure reduction, 5 had less than 50% seizure reduction, and 1 had no seizure improvement. At 6 months, 4 had greater than 50% seizure reduction 3 had less than 50% seizure reduction, and 1 had no seizure improvement. Quality of life measured by parent report of improved or not improved, referring to level of alertness, meeting developmental milestones, and overall sense of well being at 1mo 65% (n=9) patients had a reported improved quality of life, at 3mos, this value remains consistent with 60% (N=6) with continued reports of improved quality of life, and again at 6mos the patients remaining on diet 62% report improved quality. Side effects most commonly reported were gastrointestinal (GI) related, in 50% of the patients, however not severe enough to discontinue the diet. In 4 patients the side effects resolved with change in formula from Ketocal to RCF. Metobolic side effects were reported in 3 patients. These were easily corrected with adjustments of the diet. Two patients expired while on the ketogenic diet secondary to the underlying diagnosis, not as a result of the KGD. Conclusions: The ketogenic diet can be safely used in infants and neonates, with special attention to tolerability and potential side effects. Monitoring closely for both GI and metabolic complications. Our data shows that the ketogenic diet is an effective treatment for infants with intractable epilepsy, with good efficacy, and positive impact on quality of life.