The Ketogenic and Modified Atkins Diet Therapy for Children With Refractory Epilepsy of Genetic Etiology

Jagadish, Spoorthi; Payne, Eric T.; Wong‐Kisiel, Lily C.; Nickels, Katherine C.; Eckert, Susan; Wirrell, Elaine

doi:10.1016/j.pediatrneurol.2018.12.012

Cited by 33 publications

(23 citation statements)

References 29 publications

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“…Overall, all three patients responded well to the KD and showed an improvement of the EEG up to seizure freedom. These findings are equivalent to other studies demonstrating the positive effect of the KD in children with pharmaco-resistant epilepsy [ 3 , 4 , 33 , 34 ]. An improvement of cognition especially in concentration and memory performance, was reported in all three cases.…”

Section: Discussionsupporting

confidence: 90%

Monitoring Glucose Concentrations in Children with Epilepsy on a Ketogenic Diet

et al. 2022

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Ketogenic diet (KD) and pulsatile dexamethasone therapy (PDT) are commonly used in the treatment of children with drug resistant epilepsy. Potential side effects of the KD are hypoglycemia, whereas PDT might lead to hyperglycemia. One practical option to measure glucose concentrations regularly is the flash glucose monitoring system (FGM). In this single-center study in Germany, two pediatric patients with epilepsy (age: 6.0 and 6.8 years) received FGM from the beginning of the KD over six months, in the year 2020, and one patient (9.8 years) was observed for one month on PDT and switched to the KD thereafter. Glucose concentrations were measured by using an FGM system and capillary blood measurement. Seizure frequency, changes in cognition, motor performance, social behavior, and sleep quality were evaluated. The mean hypoglycemia rate per day (65 mg/dL and lower) declined significantly in patient 1 and 2 after three months. Patient 3 showed in total seven hyperglycemic events during PDT. Patient 1 became seizure free. Improvement of attention and memory performance were reported. FGM during the KD as a treatment for drug resistant epilepsies in childhood is a practical option to explore and to avoid hypoglycemia during the KD and hyperglycemia during PDT.

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Section: Discussionsupporting

confidence: 90%

Monitoring Glucose Concentrations in Children with Epilepsy on a Ketogenic Diet

et al. 2022

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“…Regarding the goal and long-term management strategy, the retention rate in the current cohort significantly increased. The retention rate at 3, 6, and 12 months was 82.0%, 60.6%, and 34.1%, respectively; these values are comparable to results from other studies [4,30,31].…”

Section: Discussionsupporting

confidence: 89%

Improving the effects of ketogenic diet therapy in children with drug-resistant epilepsy

Yang

Wen

Wei

et al. 2022

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“…The mean duration of DT was 6.6 months, which was shorter than those described in other reports. [12][13][14] Many epileptic patients have difficulty remaining on DT due to side effects, lack of efficacy, or poor compliance.…”

Section: Discussionmentioning

confidence: 99%

The Early Response to Dietary Therapy can Predict the Late Outcome in Children with Intractable Epilepsy

et al. 2021

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Background and Purpose Dietary therapy (DT), including the ketogenic diet (KD), is one of the nonpharmacological treatment options for patient with drug-resistant epilepsy. However, maintaining DT in patients without seizure reduction is very difficult, so it is critical for clinicians to decide when to stop this intervention. Methods We retrospectively analyzed early clinical and laboratory findings and the clinical characteristics of children who received DT. The maintenance of DT and the clinical seizure frequency were assessed at 1, 3, 6, 12, and 24 months after KD initiation. Responders were defined as patients showing an overall reduction in seizure frequency of >50% relative to the baseline. Results We included 67 patients who received DT, but only 23 (34.3%) of these patients remained on DT at 6 months. Only 1 (5%) of the 20 responders at 1 month became a nonresponder at 6 months. The response rate at 6 months was significantly higher among patients under 2 years of age (15/17, 88.2%) than older patients (2/6, 33.3%; p =0.021). Moreover, the 6-month responders were significantly younger (29.4±38.6 months, mean±SD) than the nonresponders (98.9±84.6 months, p =0.012) at the initiation of the diet. A high blood β-hydroxybutyrate (BHB) level at 1 month predicted a good DT response at 6 months. Conclusions Most 1-month responders maintained their response on DT for up to 6 months. The blood BHB level at 1 month was significantly correlated with the 6-month seizure outcome. Confirming clinical and laboratory biomarkers for the efficacy of DT requires further studies with larger cohorts.

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The Ketogenic and Modified Atkins Diet Therapy for Children With Refractory Epilepsy of Genetic Etiology

Cited by 33 publications

References 29 publications

Monitoring Glucose Concentrations in Children with Epilepsy on a Ketogenic Diet

Monitoring Glucose Concentrations in Children with Epilepsy on a Ketogenic Diet

Improving the effects of ketogenic diet therapy in children with drug-resistant epilepsy

The Early Response to Dietary Therapy can Predict the Late Outcome in Children with Intractable Epilepsy

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