The ketogenic diet: a review of the experience at Connecticut Children's Medical Center.
We undertook a retrospective analysis of epilepsy patients referred and treated for more than 6 months with the ketogenic diet during 1994-1999 at Connecticut Children's Medical Center. Outcome measures included antiepileptic drug number, seizure frequency, electroencephalogram background/paroxysmal activity, and adverse effects at 6 months and 1 year on the ketogenic diet. The final cohort included 24 of 48 referred patients (mean age, 6.5 years; range = 1-15 years of age). The etiology of epilepsy was equally divided between idiopathic and cryptogenic epilepsy and symptomatic epilepsy. Intention to treat analysis revealed that 35% (17 of 48) achieved more than 50% reduction in seizure frequency, and 8.5% (four of 48) were seizure-free by 6 months. A sustained 50% or greater reduction at 1 year was observed in 23% (11 of 48), and the same 8.5% (four of 48) remained seizure-free. None of these improvements were statistically related to age (P = 0.97), sex (P = 0.78), or epilepsy etiology (P = 0.80). The number of antiepileptic drugs used per patient decreased. Electroencephalogram at 1 year demonstrated an improvement in background in 31% (five of 16 patients) and a reduction in paroxysmal features in 37.5% (6 of 16 patients). Most adverse effects were mild, self-limited, and occurred early. Hyperuricemia (more than 6 mg/dL) was more persistent in three patients.
DiMario
Francis J
FJ
Department of Pediatrics, University of Connecticut School of Medicine, Division of Pediatric Neurology at Connecticut Children's Medical Center, Hartford 06106, USA.
Holland
Jessica
J
D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003237:Connecticut; D004827:Epilepsy / Q000178:diet therapy* / Q000453:epidemiology / Q000652:urine; D005260:Female; D006801:Humans; D007223:Infant; D007662:Ketosis / Q000652:urine; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome