Developmental Assessment of Infants and Children with Drug Resistant Epilepsy on Ketogenic Diet

Abstract

Background: Epilepsy is a brain disorder that being refractory to treatment represents a challenge for developing infants and children. Since the 1920s, the ketogenic diet (KD) has gained reputation as another option for patients with drug resistant epilepsy. Aim of the Work: To assess the efficacy of KD on the development of children with drug resistant epilepsy. Patients and Methods: A prospective study that involved thirty children with drug resistant epilepsy of 2-7 years age range that was held in the Pediatric Neurology and Clinical Nutrition Clinics. Patients comprised 2 groups. Group 1 included 15 patients who were scheduled to start KD and group 2 included 15 patients who were on antiepileptic drugs (AED) only. Patients were assessed initially and 3 months after commencing the study using the Stanford-Binet IQ test (SB-V), seizure evaluation included seizure frequency per week and the Chalfont Seizure Severity Scale (CSSS). Results: No difference in the initial seizure status was observed on comparison between the 2 participating groups. However, significant improvement in the seizure status in the KD group occurred at the end of the study on comparing the 2 groups’ outcomes as demonstrated by decrease in seizure frequency per week (median (IQR) =2(0.25-2)) for group(1) compared to 14(14-28) for the group(2) with a p value of 0.002. Also, CSSS scores were lower in group (1) compared to the other group 14.67+/-2.29 and 43.67+/-20.15 (mean+/-SD) respectively with a p value of 0.000. On the other hand; no difference was observed whether initially or after 3 months regarding the comparison between the 2 groups’ SB (V) IQ scores. Conclusion: KD is an effective treatment option for infants and children with drug resistant epilepsy although it didn’t affect developmental progress.