title: The efficacy of the ketogenic diet in infants and young children with refractory epilepsies using a formula-based powder.
abstract: To evaluate the efficacy, safety, and tolerability of a classic 4:1 ketogenic diet using a formula-based powder in infants and children with refractory seizures who are reluctant to eat homemade foods. We conducted an open label trial and administered a ketogenic diet using formula-based power (Ketocal®). Twenty-seven infants and children aged between 12 months and 5 years were enrolled who had refractory seizures and were reluctant to eat homemade foods. Of 27 children, 5 were lost to follow-up and 22 were remained at the end of the study. After 4 months, the median frequency of seizures per week was reduced >50% in 68.2% of patients, while 9/22 children (40.9%) showed a 50-90% reduction in seizure frequency per week, and 6/22 children (27.3%) showed more than 90% reduction in seizure frequency per week. Over the study course, 6/22 (27%) children who continued to receive the diet developed constipation, one child developed gastroesophageal reflux, and one child developed hypercholesterolemia. None of these children discontinued the diet because of the complications. Thirteen children and their parents (59%) reported that the diet was palatable and tolerable enough. The ketogenic diet using a formula-based powder (Ketocal®) is effective, safe, and tolerable in infants and children with refractory seizures who are reluctant to eat homemade foods according to the rules of the ketogenic diet.
authors.affiliation: Department of Paediatric Neurology, Growth and Development Research Center, Children's Medical Centre, Paediatrics Centre of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmoud Reza
authors.initials: MR
authors.lastname: Ashrafi
authors.affiliation: Department of Paediatrics, Golestan University of Medical Sciences, Golestan, Iran.
authors.forename: Seyed Ahmad
authors.initials: SA
authors.lastname: Hosseini
authors.affiliation: Department of Paediatric Neurology, Growth and Development Research Center, Children's Medical Centre, Paediatrics Centre of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Gholam Reza
authors.initials: GR
authors.lastname: Zamani
authors.affiliation: Department of Paediatric Neurology, Growth and Development Research Center, Children's Medical Centre, Paediatrics Centre of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Mohammadi
authors.affiliation: Department of Paediatric Neurology, Growth and Development Research Center, Children's Medical Centre, Paediatrics Centre of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Tavassoli
authors.affiliation: Department of Paediatric Neurology, Growth and Development Research Center, Children's Medical Centre, Paediatrics Centre of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Reza Shervin
authors.initials: RS
authors.lastname: Badv
authors.affiliation: Department of Paediatrics, Shahid Bahonar Children Hospital, Alborz University of Medical Sciences, Karaj, Iran.|Department of Paediatric Neurology, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Morteza
authors.initials: M
authors.lastname: Heidari
authors.affiliation: Department of Paediatrics, Ilam University of Medical Sciences, Ilam, Iran.
authors.forename: Parviz
authors.initials: P
authors.lastname: Karimi
authors.affiliation: Department of Paediatric Neurology, Golestan Medical, Educational and Research Centre, Ahvaz Jundishapur University of Medical Sciences, # 90 Golestan Blvd., P.O. Box 6135733118, Ahvaz, Iran. azizi.ramin@gmail.com.
authors.forename: Reza Azizi
authors.initials: RA
authors.lastname: Malamiri
mesh_terms: D002675:Child, Preschool; D055423:Diet, Ketogenic / Q000009:adverse effects / Q000379:methods*; D004827:Epilepsy / Q000178:diet therapy*; D005260:Female; D006801:Humans; D007223:Infant; D041943:Infant Formula; D008297:Male; D011208:Powders
chemical_list: D011208:Powders
keywords: Children; Efficacy; Infants; Ketocal®; Ketogenic diet; Refractory epilepsy