The ketogenic diet in infantile refractory epilepsy:: Electroclinical response, complications and secondary effects

Introduction. The ketogenic diet (KD) was developed after observation that prolonged starvation might lead to the seizures slopping. Due to is efficacy and safety, KD plays an important part in the management of children with refractory epilepsy. Objectives. To show the clinical anticonvulsant response of KD, the electroencephalographic changes, the need for strict methodology to enhance the success of the treatment, and evaluation of the side effects and complications observed Patients and methods. After being started on a protocol of a classical ketogenic diet, 13 patients aged between 1 and 19 years were prospectively evaluated for an average period of 22 months. All had different types of refractory epilepsy according to Schmidt's scores, as modified by Aicardi. Results. There was over 50% reduction in the number of crises of 84.5% of the children. Complete control was attained in 30.8%. The electroencephalographic recordings showed improvement in 100% of the children. The families involved reported a 58.8% reduction in the side effects observed. During treatment the serum cholesterol rose in 72.7% of the children, 36.8% complained of constipation, 27.3% had a brief period of anorexia and there was symptomatic metabolic acidosis during intercurrent infection and renal lithiasis in one patient. Conclusion. The clinical and electroencephalographic improvement and minimal side-effects seen confirm that KD is beneficial in refractory epilepsy in children.