Ketogenic Diet in Refractory Epilepsy: efficacy, evolution and long-term complicationsBackground: Ketogenic diet (KD) represents an alternative in treatment of refractory epilepsy (RE). Objective: To evaluate the efficacy of the diet and the frequency of complications in patients belonging to the KD Program from Luis Calvo Mackenna Children's Hospital (HLCM). Methods: Evaluation of all children enrolled in the program between 1999 and 2004, with analysis every 6 months of the diet efficacy, digestive tolerance, nutritional status, cholesterol levels and nephrolithiasis. Results: 21 children were admitted, 14 boys, age between 6 months -17 years-old. 76%, 71% and 67% of patients followed KD at 6, 12 and 18 months, respectively, with KD efficacy of 67%. At 12 months, 24% of patients did not present seizures. At 18 months, 85% remained close to ideal body weight (15% obesity) and height/age Z score decreased (-0,7 ± 0,4; p < 0,05). Total cholesterol significantly increased at 6 months (64% hypercholesterolemia; decreased to 15% at 18 months). 2 patients developed nephrolithiasis. Conclusions:The study shows high efficacy of the KD for treatment of refractory epilepsy, with low rate of complications. It should be considered as a therapeutic alternative for these patients. (

Forty seven children were followed up for one year, after their first epileptic seizure, without treatment. Six patients (12,8°,/o) had a second episode, in five of them the fust crisis been tonic and generalized, in one been a typical Grand Mai convulsion; in three of this cases the second episode had the same clinical pattern than the first one. The age of onset seems not to have any predictive value. EEC records showed slow and paroxistic electric patterns in those children with a second seizure.Cuando un enfermo presenta por primera vez una crisis epileptica, se plantea al medico el importante desafio de si se debe o no recomendar un tratamiento antiepileptico. La decision deberia estar basada en el conocimiento del pronostico de la crisis y de los factores predictores de recurrencia de nuevos episodios. Las opiniones al respecto son variadas^2" 3 " 4 ' 5 " 6 " 7 ' 8 . Las investigaciones son escasas y las diferentes metodologias empleadas las hacen diffcilmente comparable* entre si El objetivo de esta comunicacion preliminar es dar cuenta de los resultados obtenidos en un grupo de nifios que tuvieron una crisis epileptica no tratada, que nan sido observados por lo menos 1 afio despue"s de su primer episodic y hacer referenda a la edad de comienzo, tipo de crisis y EEC. El proyecto contempla un periodo de seguimiento de 3 aflos para cada enfermo. MATERIAL Y METODOHasta mayo de 1983, se incorporaron al estudio 88 nifios que cumplian los siguientes requisi-

No abstract