title: Ketogenic diet in patients with Lennox-Gastaut syndrome.
abstract: OBJECTIVE
  The ketogenic diet (KD) has been used as an alternative to antiepileptic drugs (AEDs) for patients with refractory epilepsy. Lennox-Gastaut syndrome (LGS) belongs to the group of epileptic encephalopathies that often prove refractory to AED treatment. In this prospective study we assess the efficacy and tolerability of the KD in patients with LGS.
  
  
  METHODS
  Between March 1, 1990 and April 1, 2013, 61 patients who met diagnostic criteria of LGS were seen at our department. Twenty of them were placed on the KD and followed for a minimum of 16 months.
  
  
  RESULTS
  The children had previously received a mean of 6.5 different AEDs and were on a mean of 2.5 AEDs when the diet was started. Eighteen months after initiating the diet, fifteen of the initial patients (75%) remained on the diet; three patients (15%) were seizure free, three (15%) had a 75-99% decrease in seizures, two (10%) had a 50-74% decrease in seizures, and the remaining seven children (35%) had a <50% decrease in seizures. Three seizure-free patients were tapered off the diet after remaining seizure free. In the three patients who had a 75-99% decrease in seizures AEDs were reduced.
  
  
  CONCLUSIONS
  The KD is an effective and well-tolerated treatment option for patients with LGS, not only for those with cryptogenic, but also for those with structural LGS. The diet should be considered early in the course of this syndrome.
authors.affiliation: Servicio de Neurología, Hospital de Pediatría "Prof Dr Juan P Garrahan", Buenos Aires, Argentina. Electronic address: rhcaraballo@arnet.com.ar.
authors.forename: Roberto Horacio
authors.initials: RH
authors.lastname: Caraballo
authors.affiliation: Servicio de Neurología, Hospital de Pediatría "Prof Dr Juan P Garrahan", Buenos Aires, Argentina.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Fortini
authors.affiliation: Servicio de Neurología, Hospital de Pediatría "Prof Dr Juan P Garrahan", Buenos Aires, Argentina.
authors.forename: Santiago
authors.initials: S
authors.lastname: Fresler
authors.affiliation: Hospital de Pediatría "Prof Dr Juan P Garrahan", Buenos Aires, Argentina.
authors.forename: Marisa
authors.initials: M
authors.lastname: Armeno
authors.affiliation: Hospital de Pediatría "Prof Dr Juan P Garrahan", Buenos Aires, Argentina.
authors.forename: Agustinho
authors.initials: A
authors.lastname: Ariela
authors.affiliation: Hospital de Pediatría "Prof Dr Juan P Garrahan", Buenos Aires, Argentina.
authors.forename: Araceli
authors.initials: A
authors.lastname: Cresta
authors.affiliation: Hospital de Pediatría "Prof Dr Juan P Garrahan", Buenos Aires, Argentina.
authors.forename: Graciela
authors.initials: G
authors.lastname: Mestre
authors.affiliation: Hospital de Pediatría "Prof Dr Juan P Garrahan", Buenos Aires, Argentina.
authors.forename: Nidia
authors.initials: N
authors.lastname: Escobal
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D055423:Diet, Ketogenic / Q000379:methods*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D065768:Lennox Gastaut Syndrome / Q000178:diet therapy* / Q000188:drug therapy; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: Epileptic encephalopathy; Ketogenic diet; Lennox–Gastaut syndrome; Refractory epilepsy; Seizures