title: Ketogenic diet effects on neurobehavioral development of children with intractable epilepsy: A prospective study.
abstract: OBJECTIVE
  This study aimed to determine the impact of a ketogenic diet (KD) on neurobehavioral development when used to treat children with intractable epilepsy, confirming the efficacy of the KD, as well as the correlation between early electroencephalography (EEG) changes in the early stage with treatment efficacy.
  
  
  METHODS
  We enrolled 42 children who were starting treatment for intractable epilepsy with the classic KD protocol. The total development quotient as well as the development quotients for adaptability, gross motor movements, fine motor movements, language, and individual-social interaction on the Gesell developmental scales were assessed before and after 3, 6, 12, and 18 months of KD treatment. The efficacy assessment was based on changes in seizure frequency after KD as recorded by the parents. We conducted 24-h video-EEG before and after 1 month of KD treatment.
  
  
  RESULTS
  Developmental quotients of five energy regions in the Gesell developmental scales assessment were used to compare adaptability (P1=0.000), gross motor movements (P2=0.010), and fine motor movements (P3=0.000); the results showed significant differences. After KD treatment at different time points, 69.0%, 54.8%, 40.5%, and 33.3% patients, respectively, achieved a ≥50% reduction in seizure frequency. The reduction of epileptiform discharges in the awake state after 1 month of KD treatment correlated with the efficacy after 3 months of KD treatment.
  
  
  CONCLUSIONS
  Ketogenic diet treatment tends to be associated with improved neurobehavioral development, and more significant improvement can be obtained with prolonged treatment. The KD is safe and effective in treating children with intractable epilepsy. Early EEG changes correlate with clinical efficacy, to a certain degree.
authors.affiliation: Cerebral Palsy Rehabil. Dept., Zhengzhou Univ., Affiliated Hosp 3, Zhengzhou 450052, Henan, PR China. Electronic address: zhudengna@126.com.
authors.forename: Dengna
authors.initials: D
authors.lastname: Zhu
authors.affiliation: Cerebral Palsy Rehabil. Dept., Zhengzhou Univ., Affiliated Hosp 3, Zhengzhou 450052, Henan, PR China.
authors.forename: Mingmei
authors.initials: M
authors.lastname: Wang
authors.affiliation: Cerebral Palsy Rehabil. Dept., Zhengzhou Univ., Affiliated Hosp 3, Zhengzhou 450052, Henan, PR China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Cerebral Palsy Rehabil. Dept., Zhengzhou Univ., Affiliated Hosp 3, Zhengzhou 450052, Henan, PR China.
authors.forename: Junying
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Cerebral Palsy Rehabil. Dept., Zhengzhou Univ., Affiliated Hosp 3, Zhengzhou 450052, Henan, PR China.
authors.forename: Guohui
authors.initials: G
authors.lastname: Niu
authors.affiliation: Cerebral Palsy Rehabil. Dept., Zhengzhou Univ., Affiliated Hosp 3, Zhengzhou 450052, Henan, PR China.
authors.forename: Guangyu
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Cerebral Palsy Rehabil. Dept., Zhengzhou Univ., Affiliated Hosp 3, Zhengzhou 450052, Henan, PR China.
authors.forename: Li
authors.initials: L
authors.lastname: Sun
authors.affiliation: Cerebral Palsy Rehabil. Dept., Zhengzhou Univ., Affiliated Hosp 3, Zhengzhou 450052, Henan, PR China.
authors.forename: Huachun
authors.initials: H
authors.lastname: Xiong
authors.affiliation: Department of Pediatrics, First People Hospital of Zhengzhou, Zhengzhou 450000, Henan, PR China.
authors.forename: Mengmeng
authors.initials: M
authors.lastname: Xie
authors.affiliation: Cerebral Palsy Rehabil. Dept., Zhengzhou Univ., Affiliated Hosp 3, Zhengzhou 450052, Henan, PR China.
authors.forename: Yunxia
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D002648:Child; D002657:Child Development; D002675:Child, Preschool; D055423:Diet, Ketogenic / Q000379:methods*; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis* / Q000178:diet therapy* / Q000523:psychology; D004569:Electroencephalography / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Intractable epilepsy; Ketogenic diet; Neurobehavioral development; Video-electroencephalography