Long-term effective rate, retention rate and tolerability of the ketogenic diet in paediatrics drug-resistant epilepsies

Abstract

Objective To evaluate the long-term effective rate, retention rate and tolerability of the ketogenic diet (KD) in pediatric drug-resistant epilepsies. Methods Data of 36 children who were treated in Department of Pediatrics, the Second Affiliated Hospital of Xi'an Jiaotong University from Nov.2011 to Dec.2013 and had continuous follow-up of at least 12 months after initiation of the KD were analyzed prospectively.Response was defined as 50% seizure reduction.The effective rate, retention rate, outcome-predictive value of various clinical factors were also assessed.The causes of the patients withdrew from KD and side effects were recorded and analyzed. Results Thirty-six children(29 boys, 7 girls; mean age of 2.84 years)were included.The effective rate was 50.0%, 52.8%, 47.2% and 41.7% at the 1, 3, 6, 12 months; the retention rate respectively was 94.4%, 91.2%, 69.4% and 52.8%.Seventeen cases withdrew from KD.Seven cases (41.2%)ceased KD because of a lack of compliance, 5 patients because of poor outcome, and 2 cases because of repeated infection.None of the age, disease duration, etiology and seizure type could be used as the predictor for the favourable treatment for outcome.The antiepileptic drugs before KD might be predicted the efficacy of the KD.The less amount of the antiepileptic drugs, the more opportunity of the KD might have to succeed.The side effects on the start-up period were drowsiness, week and digestive discomfort, hyperlipoidemia, hypoglycemia and hepatic dysfunction.The side effects on the maintenance period were digestive discomfort, susceptibility to infection, hyperlipoidemia, the deficiency of trace elements. Conclusions The KD is a safe and potentially effective method in treatment of refractory epilepsy patients who do not respond to customary medication therapies. Key words: Ketogenic diet; Refractory epilepsy; Effective rate; Retention rate; Side effect