Abstract
Introduction: Epilepsy is a neurological disorder characterized by an increased susceptibility to seizures. The ketogenic diet (KD) is currently the most important alternative non-pharmacological treatment. Despite its long history of clinical use, it is not clear how this diet affects longitudinal growth in children. Methods: A prospective study was designed to evaluate growth and nutritional status in 45 children on KD. Growth was assessed by measuring weight, height, and body mass index (BMI). Standard deviation scores (SDS) were calculated for all measurement parameters at KD initiation and at a two-year follow-up. Results: Overall, 45 patients who completed 24 months on KD were enrolled. Median age was 6.6 years (0.8 to 17.3), with a male predominance (n = 23); 74% of the 45 patients were responders on seizure reduction at three months; 26% of patients were non-responders. In our study, using −1 SDS as a cut-off point, growth deceleration was observed in 9% (n: 4) of the patients; however, the nutritional status was maintained or even improved. No correlation with age, sex, or ambulatory status was found. Conclusions: The nutritional follow-up of these patients was helpful to improve overweight and thinness but could not avoid growth deceleration in some of them. These findings confirm that children with refractory epilepsy on KD treatment require careful growth monitoring.
Highlights
Epilepsy is a neurological disorder characterized by an increased susceptibility to seizures
We evaluated growth in a subgroup of a cohort of patients that are being prospectively followed-up to determine the long-term effects of ketogenic diet (KD) treatment for refractory epilepsy on growth and nutritional status
In our series, body mass index (BMI) improved after 24 months on KD, while good nutritional status was maintained in all patients
Summary
Epilepsy is a neurological disorder characterized by an increased susceptibility to seizures. Median age was 6.6 years (0.8 to 17.3), with a male predominance (n = 23); 74% of the 45 patients were responders on seizure reduction at three months; 26% of patients were non-responders. Despite its long history of clinical use, it is not clear how this diet affects longitudinal growth in children [1]. This is important as the KD is often used as a long-term therapy in different epileptic syndromes [2,3,4], such as Dravet syndrome, epilepsy with myoclonic-atonic seizures, Lennox–Gastaut syndrome.
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