Turkey: The Ketogenic Diet and Pediatric Drug-Resistant Epilepsy

The ketogenic diet (KD) is clinically effective for the treatment of pediatric drug-resistant epilepsy (DRE) and significantly reduces the frequency of epileptic discharges, claims a recent study published in the Turkish Journal of Pediatrics. In addition, the diet significantly increased total cholesterol and LDL-C levels and significantly decreased fasting blood glucose levels compared to baseline levels.

Gonca Kılıç Yıldırım, Divisions of Child Nutrition and Metabolism, Eskisehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey, and colleagues aimed to evaluate the effect of the ketogenic diet on children with drug-resistant epilepsy in terms of anthropometric measurements, clinical effectiveness, and some electroencephalogram (EEG) and biochemical findings.

The study included 18 children (median age 70 months, 61.1% female) who received the classical ketogenic diet and modified Atkins diet (MAD) for at least one year due to DRE. The researchers recorded demographic and laboratory data; height, weight, and body mass index values; abdominal ultrasonography findings; EEG and electrocardiographic findings; and biochemical parameters at baseline and at 12 months after the initiation of the diet. A reduction of ≥50% in the number of seizures was accepted as a response to KD.

Study Findings

• Classic KD was chosen for 77.8% of the patients, and MAD for 22.2% of patients.
• The response to KD therapy (≥50% reduction) was 55.5%, and one patient even became seizure-free.
• By the 12th month of treatment, 10 patients had experienced a reduction of more than 50% in epileptiform discharges, as indicated by EEG findings.
• There was no difference in seizure reduction between the patients who received classical KD and MAD.
• A total of 11.1% of the children lost weight during KD treatment.
• The most common side effect was constipation (n = 10, 55.6%).
• At the end of one year of treatment, total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels had increased dramatically, while fasting blood glucose levels had decreased significantly.

"Our findings indicate that KD treatment provides good clinical efficacy in the treatment of pediatric DRE, and can significantly reduce the frequency of epileptic discharges," the researchers wrote. "Also, LDL-C and total cholesterol levels increased significantly, and fasting blood glucose levels decreased significantly compared to the baseline levels."

Reference

Yıldırım, Gonca Kılıç, et al. "Evaluation of Ketogenic Diet Therapy in Children Diagnosed With Drug-resistant Epilepsy: a Single-center Experience." The Turkish Journal of Pediatrics, vol. 64, no. 3, 2022, pp. 435-445.