Abstracts

Rationale: We report the effect of ketogenic diet (KD) to treat infantile spasms (IS) as a third-line treatment, after vigabatrin (VGB) and oral steroid. We aimed to evaluate the efficacy and the tolerability of KD in IS using the rate of seizure-free patient at 1 month because of the prognosis of this epilepsy syndrome Methods: We report 17 patients treated by KD for IS. The data were extracted from a prospective database of 2 French child neurology departments (Amiens & Robert Debré-Paris, France) over a 18 month period. Follow-up clinic visits with EEG were done at 1, 3, 6 and 12 months after initiating the diet were scheduled to access efficacy and tolerability. All the patients were followed the KD for 6 months. The addiction of an antiepileptic drug was allowed after 1 month of KD Results: The KD was initiated at the mean age of 9.4±1.1 months. After 1 month with KD 6/17 (35%) were seizure free while 11/17 (65%) were seizure-free after the third month. However, an additional antiepileptic drug (felbamate or topiramate) has been added in all patients that were not seizure free under KD. Conclusions: All patients but one were treated by KD before the age of 1 year. The KD was used early in the treatment of IS (Third-line treatment). Comparing our data to previous studies, it seems that the responders rate in case of IS is similar regardless the age of the patient and the precocity of the KD in the management of IS. We also found that an additional AED may significantly improve the rate of seizure control.