Effects of a Formula-Based Ketogenic Diet on Refractory Epilepsy in 1 to 3 Year-Old Patientsunder Classic Ketogenic Diet
Iranian Journal of Child Neurology,
Vol. 13 No. 4 (2019),
7 September 2019
Objectives: The classic ketogenic diet (CKD) as a potential epilepsy treatment with high-fat has not a good tolerability in some patients, and so many families refuse to use this diet for long term especially in children younger than 2 years of age. In the present study, the efficacy and tolerability of the only CKD was compared with CKD combined a formula-based powder in children between 1 and 3 years of age with intractable epilepsy.
Material and Methods: We prospectively enrolled 45 children with refractory epilepsy for CKD (control group), and CKD combined with a formula-based powder (experimental group) treatment. Subjects were followed up for at least six months.
Results: Most of the patients in control group did not tolerate the diet and were reluctant to eat homemade foods with high fat, as all the families of the patients younger than 2 years old in this group chose to discontinue the CKD and pursued other options. 33% of the families of patients younger than 2 years old and totally 41.6% patients between 1-3 years old in experimental group stayed to the end of the trial, and all of them showed more than 90% reduction in seizure frequency after 6 months. Also, regardless of the other variables, the formula increased the chance of responding to treatment 7.32 times.
Conclusions: A ketogenic diet using a formula-based powder is effective, safe, and tolerable in infants and children with refractory seizure especially for younger patients who are reluctant to eat homemade foods.
- Ketogenic diet
- Refractory seizure
How to Cite
Alaei M, GHAZAVI MR, Mahvelati F, Karimzadeh P, SHIVA MR, TONEKABONI SH. The effect of the ketogenic diet on the growth and biochemical parameters of the children with resistant epilepsy. Iranian Journal of Child Neurology. 2010;3(4):41-4.
BarzegarM, Irandoust P, Mameghani ME. Modified tkins Diet for intractable childhood epilepsy. Iranian Journal of Child Neurology. 2010;4(3):15-20.
Karimzadeh P, Tabarestani S, Mahvelati F, Tonekaboni S, Ghofrani M. Intractable seizure disorders: Efficacy of the classic ketogenic diet. Iranian Journal of Child Neurology. 2009;3(1):15-20.
Bailey EE, Pfeifer HH, Thiele EA. The use of diet in the treatment of epilepsy. Epilepsy & Behavior. 2005;6(1):4-8.
Kossoff EH, Wang H-S. Dietary therapies for epilepsy. Biomed J. 2013;36(1):2-8.
Karimzadeh P, Sedighi M, Beheshti M, Azargashb E, Ghofrani M, Abdollahe-Gorgi F. Low Glycemic Index Treatment in pediatric refractory epilepsy: the first Middle East report. Seizure. 2014;23(7):570-2.
MIRJAVADI SA, TONEKABONI SH, GHAZAVI M, AZARGASHB E, GORJI FA, GHOFRANI M. Efficacy of The Ketogenic Diet as A Therapy for Intractable Epilepsy in Children. Iranian Journal of Child Neurology. 2010;4(2):27-36.
Ashrafi MR, Hosseini SA, Zamani GR, Mohammadi M, Tavassoli A, Badv RS, et al. The efficacy of the ketogenic diet in infants and young children with refractory epilepsies using a formula-based powder. Acta Neurologica Belgica. 2017;117(1):175-82.
Kossoff EH, Dorward JL, Turner Z, Pyzik PL. Prospective study of themodified Atkins diet in combination with a ketogenic liquid supplement during the initial month. Journal of child neurology. 2011;26(2):147-51.
Coppola G, Verrotti A, Ammendola E, Operto FF, della Corte R, Signoriello G, et al. Ketogenic diet for thetreatment of catastrophic epileptic encephalopathies in childhood. European journal of paediatric neurology. 2010;14(3):229-34.
El‐Rashidy O, Nassar M, Abdel‐Hamid I, Shatla R, Abdel‐Hamid M, Gabr S, et al. Modified Atkins diet vs classic ketogenic formula in intractable epilepsy. Acta Neurologica Scandinavica. 2013;128(6):402-8.
Kossoff EH, Zupec‐Kania BA, Amark PE, Ballaban‐Gil KR, Christina Bergqvist A, Blackford R, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009;50(2):304-17.
Neal EG, Chaffe H, Schwartz RH, Lawson MS, Edwards N, Fitzsimmons G, et al. The ketogenic diet for the treatment of childhood epilepsy: a randomised controlled trial. The Lancet Neurology. 2008;7(6):500-6.
Freeman JM, Vining EP, Pillas DJ, Pyzik PL, Casey JC. The efficacy of the ketogenic diet—1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998;102(6):1358-63.
De Vivo DC, Trifiletti RR, Jacobson RI, Ronen GM, Behmand RA, Harik SI. Defective glucose transport across the blood-brain barrier as a cause of persistent hypoglycorrhachia, seizures, and developmental delay. New England Journal of Medicine. 1991;325(10):703-9.
Klepper J, Leiendecker B. GLUT1 deficiency syndrome–2007 update. Developmental Medicine & Child Neurology. 2007;49(9):707-16.
Pons R, Collins A, Rotstein M, Engelstad K, De Vivo DC. The spectrum of movement disorders in Glut‐1 deficiency. Movement Disorders. 2010;25(3):275-81.
Wexler I, Hemalatha S, McConnell J, Buist N, Dahl HM, Berry S, et al. Outcome of pyruvate dehydrogenase deficiency treated with ketogenic diets Studies in patients with identical mutations. Neurology. 1997;49(6):1655-61.
Groesbeck DK, Bluml RM, Kossoff EH. Long-term use of the ketogenic diet in the treatment of epilepsy. Developmental medicine and child neurology. 2006;48(12):978-81.
Huttenlocher P, Wilbourn A, Signore J. Medium-chain triglycerides as a therapy for intractable childhood epilepsy. Neurology. 1971;21(11):1097-103.
Schwartz RH, Eaton J, Bower B, Aynsley‐Green A. KETOGENIC DIETS IN THE TREATMENT OF EPILEPSY: SHORT‐TERM CLINICAL EFFECTS. Developmental Medicine & Child Neurology. 1989;31(2):145-51.
Freeman JM, Kossoff EH, Hartman AL. The ketogenic diet: one decade later. Pediatrics. 2007;119(3):535-43.
Freeman J, Veggiotti P, Lanzi G, Tagliabue A, Perucca E. The ketogenic diet: from molecular mechanisms to clinical effects. Epilepsy Res. 2006;68(2): 80-145 .
- Abstract Viewed: 181 times
- PDF Downloaded: 5 times