Effectiveness of the ketogenic diet in a broad range of seizure types and EEG features for severe childhood epilepsies

• Published in: Acta neurologica Scandinavica Vol. 121; no. 1; pp. 58 - 62
• Main Authors: Beniczky, S., Jose Miranda, M., Alving, J., Heber Povlsen, J., Wolf, P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.2010; Blackwell
• Subjects: Biological and medical sciences; Child, Preschool; Confidence Intervals; Diet, Ketogenic; Diseases of striated muscles. Neuromuscular diseases; electroencephalogram; Electroencephalography; epilepsy; Epilepsy - classification; Epilepsy - diagnosis; Epilepsy - diet therapy; Epilepsy, Temporal Lobe - diagnosis; Epilepsy, Temporal Lobe - diet therapy; Epilepsy, Temporal Lobe - epidemiology; Female; Humans; ketogenic diet; Male; Medical sciences; Neurology; Predictive Value of Tests; predictors; Severity of Illness Index; Treatment Outcome; Human; predictors; Nervous system diseases; Epilepsy; Electrophysiology; Electroencephalography; electroencephalogram; Feeding; Cerebral disorder; Convulsion; Diet; ketogenic diet; Central nervous system disease; Neurological disorder; Child
• ISSN: 0001-6314; 1600-0404
• DOI: 10.1111/j.1600-0404.2009.01303.x

Background –  Ketogenic diet (KD) is an effective treatment for pharmacoresistant epilepsy: more than half of the patients show a greater than 50% reduction in seizures. Objective –  To identify clinical or electroencephalogram (EEG) variables predicting the response to KD. Methods –  Clinical and EEG data were retrospectively analysed from 50 consecutive patients treated by KD for severe, pharmacoresistant epilepsy. Most of the patients (70%) had retarded mental and motor development. Results –  Three months after the start of the KD two‐thirds (33) of the patients were responders (had a more than 50% reduction in seizure frequency). The presence of epileptiform EEG discharges in the temporal region correlated with an unfavourable response (P = 0.03). The presence of bilateral synchronous epileptiform discharges, and the presence of complex partial seizures approached significance but all other variables did not. Conclusions –  Our results further support that KD is efficient in a wide variety of epileptic patients with a broad range of EEG features. However, patients with epileptiform discharges in the temporal region are less likely to achieve therapeutic response.