The Efficacy of the Ketogenic Diet in Improving Seizures and EEG Findings in Patients with Refractory Infantile Spasms
Iranian Journal of Child Neurology,
Vol. 16 No. 4 (2022),
Infantile spasm is an epileptic disorder of early childhood and infancy and is characterized by cluster epileptic spasms and abnormal EEG findings. Developmental delay is prevalent. Some studies have
indicated the significant effect of the Ketogenic Diet (KD) on intractable spasms in children who are unresponsive to first-line treatments. It has been used successfully as a first-line treatment with
fewer side effects than ACTH.
Materials & Methods
This was an interventional study in which the effectiveness of KD over a six-month period was evaluated in patients with infantile spasms. Those who fulfilled the inclusion criteria and were willing to
use the diet received free cans of the 4:1 ketogenic formula. The diet was prescribed based on the Johns Hopkins protocol in the outpatient setting. All patients used a full formula diet for one month. After a month, the patients were examined by a neurologist and a dietitian, and an EEG was obtained to compare pre- and post-KD findings. In order to compare pre- and post-KD seizures, the maximum number of seizures was multiplied by the longest duration of seizures
Ten patients were assessed for one month. Using the KD led to significant changes in seizures/clusters and EEG findings. Nine parents reported improvement in their children’s social interactionsafter using the KD.
Based on the findings of this study, the KD can control seizures in patients suffering from infantile spasms by reducing seizure frequency & duration and improving EEG findings
- infantile spasm; ketogenic diet; refractory seizure
How to Cite
2. Wirrell EC, Shellhaas RA, Joshi C, Keator C, Kumar S, Mitchell WG. How should children with West syndrome be efficiently and accurately investigated? Results from the National Infantile Spasms Consortium. Epilepsia. 2015;56(4):617-25.
3. Hancock EC, Osborne JP, Edwards SW. Treatment of infantile spasms. Cochrane Database Syst Rev. 2013(6):Cd001770.
4. Go CY, Mackay MT, Weiss SK, Stephens D, Adams-Webber T, Ashwal S, et al. Evidence-based guideline update: medical treatment of infantile spasms. Report of the Guideline Development Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2012;78(24):1974-80.
5. Freeman JM, Kossoff EH, Hartman AL. The ketogenic diet: one decade later. Pediatrics. 2007;119(3):535-43.
6. Eun SH, Kang HC, Kim DW, Kim HD. Ketogenic diet for treatment of infantile spasms. Brain Dev. 2006;28(9):566-71.
7. Hirano Y, Oguni H, Shiota M, Nishikawa A, Osawa M. Ketogenic diet therapy can improve ACTH-resistant West syndrome in Japan. Brain Dev. 2015;37(1):18-22.
8. Hong AM, Turner Z, Hamdy RF, Kossoff EH. Infantile spasms treated with the ketogenic diet: prospective single-center experience in 104 consecutive infants. Epilepsia. 2010;51(8):1403-7.
9. Kossoff EH, Pyzik PL, McGrogan JR, Vining EP, Freeman JM. Efficacy of the ketogenic diet for infantile spasms. Pediatrics. 2002;109(5):780-3.
10. Lee J, Lee JH, Yu HJ, Lee M. Prognostic factors of infantile spasms: role of treatment options including a ketogenic diet. Brain Dev. 2013;35(8):821-6.
11. Pires ME, Ilea A, Bourel E, Bellavoine V, Merdariu D, Berquin P, et al. Ketogenic diet for infantile spasms refractory to first-line treatments: an open prospective study. Epilepsy Res. 2013;105(1-2):189-94.
12. Song JM, Hahn J, Kim SH, Chang MJ. Efficacy of Treatments for Infantile Spasms: A Systematic Review. Clin Neuropharmacol. 2017;40(2):63-84.
13. Prezioso G, Carlone G, Zaccara G, Verrotti A. Efficacy of ketogenic diet for infantile spasms: A systematic review. Acta Neurol Scand. 2018;137(1):4-11.
14. Kossoff EH, Hedderick EF, Turner Z, Freeman JM. A case-control evaluation of the ketogenic diet versus ACTH for new-onset infantile spasms. Epilepsia. 2008;49(9):1504-9.
15. Freeman J, Kossoff E, Freeman J, Kelly M. The ketogenic diet: a treatment for epilepsy in children and others. Demos, New York. 2006.
16. Kossoff EH, McGrogan JR, Freeman JM. Benefits of an all-liquid ketogenic diet. Epilepsia. 2004;45(9):1163.
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