title: The ketogenic diet as a treatment option in adults with chronic refractory epilepsy: efficacy and tolerability in clinical practice.
abstract: The ketogenic diet (KD) is a high-fat, low-protein, low-carbohydrate diet that is used as a treatment for patients with difficult-to-control epilepsy. The present study assesses the efficacy and tolerability of the KD as an add-on therapy in adults with chronic refractory epilepsy. 15 adults were treated with the classical diet or MCT diet. During a follow-up period of 1 year we assessed seizure frequency, seizure severity, tolerability, cognitive performance, mood and quality of life (QOL). We found a significant reduction in seizures among the patients who followed the diet at least 1 year (n=5). Of these 5 patients, 2 had a reduction between 50 and 90%. Analyzing the study months separately, we found a seizure reduction of ≥50% in 26.6% of the patients during at least 1 month of treatment. Common side-effects were gastrointestinal disorders, loss of weight and fatigue. There was a considerable, non-significant improvement found in mood and QOL scores. Improvements were independent of reduction in seizure frequency, indicating that the effects of the KD reach further than seizure control.
authors.affiliation: Department of Neurology, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands. lambrechtsd@kempenhaeghe.nl
authors.forename: Danielle A J E
authors.initials: DA
authors.lastname: Lambrechts
authors.forename: Laura H P
authors.initials: LH
authors.lastname: Wielders
authors.forename: Albert P
authors.initials: AP
authors.lastname: Aldenkamp
authors.forename: Fons G H
authors.initials: FG
authors.lastname: Kessels
authors.forename: Reina J A
authors.initials: RJ
authors.lastname: de Kinderen
authors.forename: Marian J M
authors.initials: MJ
authors.lastname: Majoie
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002908:Chronic Disease; D055423:Diet, Ketogenic / Q000009:adverse effects / Q000379:methods*; D004644:Emotions / Q000502:physiology; D004827:Epilepsy / Q000178:diet therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011581:Psychological Tests; D011788:Quality of Life; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants