No abstract available.
Ketogenic Diet*

Objective: To evaluate the long-term efficacy, retention rate and tolerability of ketogenic diet treatment (KD) for children with medically refractory epilepsies from a single tertiary centre in Malaysia. Methods: Children who were treated with ketogenic diet since 2006 and had at least 2 years follow up after initiation of the KD were evaluated retrospectively using intention-to-treat principle. Response is defined at seizure reduction of > 50%. Efficacy was assessed as percentage of patients who had seizure reduction by >50%, >90% and seizure freedom and retention rate was the proportion of patients who remained on ketogenic diet. Result: A total of thirty children were included. The median duration of treatment was 8 months (range: 7 days to 6 years). Retention rates at 3, 6, 12 and 24 months were 80%, 70%, 50% and 40% and responder rates were 70%, 63%, 47% and 37% respectively. The common adverse effects were constipation (43%), hunger (23%), excessive weight gain or loss (20%), vomiting (10%), hyperuricaemia(30%), hypocalcaemia (20%) and renal calculi (13%). The common reasons for stopping were because the diet was too restrictive (33%), infrequent seizure or seizure freedom (23%), not effective (17%) but none was due to the adverse effects. Conclusion: Ketogenic diet treatment is effective and well-tolerated by Malaysian children in general.
Ketogenic Diet ; Epilepsy

No abstract available.
Animals* ; Ketogenic Diet* ; Models, Animal*

The ketogenic diet (KD) is an established, effective, nonpharmacologic treatment for children with pharmacoresistant epilepsy. Although the KD is the most well-established dietary therapy for epilepsy, it is too restrictive and is associated with serious complications; therefore, alternative lower-fat diets, including a modified Atkins diet and low-glycemic index diet, have been developed. Recent ongoing clinical evidence suggests that other dietary therapies have an efficacy almost comparable to that of the KD. In addition, a diet rich in polyunsaturated fatty acids appears to increase the efficacy of diet therapy and reduce the complications of a high-fat diet. Here, we review the systematic information about lower-fat diets and better-quality dietary therapies and the current clinical status of each of these dietary approaches.
Child ; Diet ; Diet, Carbohydrate-Restricted ; Diet, High-Fat ; Epilepsy ; Fatty Acids, Unsaturated ; Humans ; Ketogenic Diet

In this paper, we report on a 5-year-old girl who developed a renal stone while following the ketogenic diet to treat refractory seizure disorder. Three months after initiating the ketogenic diet, she developed severe abdominal pain and vomiting. The spot urine calcium-to-creatinine (Ca/Cr) ratio and 24-hour urine evaluation showed hypercalciuria. Computed tomography (CT) imaging revealed a stone in the right ureteropelvic junction, resulting in hydronephrosis of the right kidney. The renal stone disappeared 5 days after conservative treatment; the patien's microscopic hematuria resolved concurrently. In light of this case report, we recommend regularly monitoring the urine Ca/Cr ratio with ultrasonography for further development of renal stones in patients following the ketogenic diet. If these patients exhibit evidence of symptomatic hypercalciuria or cyristalluria, liberalization of fluid restriction and urine alkalization using oral potassium citrate should be considered.
Child, Preschool ; Epilepsy/*diet therapy ; Female ; Humans ; Ketogenic Diet/*adverse effects/methods ; Kidney Calculi/*etiology

Ketogenic diet is a high-fat, low-carbohydrate, low-protein diet used in the treatment of epilepsy since 1920's. Recently, it's use for intractable epilepsy in childhood has increased. Complications of ketogenic diet are known to include dehydration, vomiting, diarrhea, renal stones, metabolic derangement, hypercholesterolemia and refusal to eat. We experienced two cases of renal stones in children with intractable epilepsy during ketogenic diet.
Child ; Dehydration ; Diarrhea ; Diet, Protein-Restricted ; Disulfiram ; Epilepsy ; Humans ; Hypercholesterolemia ; Ketogenic Diet* ; Vomiting

BACKGROUND AND PURPOSE: Despite the successful use of a ketogenic diet in pediatric epilepsy, its application in adults has been limited. The aim of this meta-analysis was to summarize the findings of relevant published studies in order to identify the efficacy of and compliance with a ketogenic diet and its main subtypes (i.e., classic ketogenic diet and modified Atkins diet) in adults with intractable epilepsy, and to provide useful information for clinical practice. METHODS: Electronic searches of PubMed, EMBASE, Google Scholar, and the ISI Web of Science were conducted to identify studies of the efficacy of and patient compliance with a ketogenic diet in adults with intractable epilepsy; the included studies were reviewed. Meta-analyses were performed using STATA to determine combined efficacy rates and combined rates of compliance with the ketogenic diet and its main subtypes. RESULTS: In total, 12 studies qualified for inclusion, and data from 270 patients were evaluated.The results of the meta-analysis revealed combined efficacy rates of all types of ketogenic diet, a classical ketogenic diet, and a modified Atkins diet were 42%, 52%, and 34%, respectively; the corresponding combined compliance rates were 45%, 38%, and 56%. CONCLUSIONS: The results indicate that a ketogenic diet is a promising complementary therapy in adult intractable epilepsy, and that while a classical ketogenic diet may be more effective, adult patients are likely to be less compliant with it than with a modified Atkins diet.
Adult* ; Compliance ; Diet, Carbohydrate-Restricted ; Epilepsy* ; Humans ; Ketogenic Diet* ; Patient Compliance*

PURPOSE: Ketogenic diet(KD) is an alternative treatment for children with intractable seizures. This study was performed to evaluate the efficacy and tolerability of ketogenic diet METHODS: A retrospective study was performed for 57 patients(31 males, and 25 females), who were enrolled in a ketogenic diet program from 1998 to 2003 in Seoul National University Children's Hospital. We investigated the overall efficacy, influencing factors such as age at diet onset, seizure type, initial fasting, adverse events and reasons for discontinuing the diet. RESULTS: The patients mean age at diet onset was 3.5 years old. They had 3.14 medications on average at the diet initiation. One month after the diet initiation, 49 of 57(86 %) remained on KD, with 37(64.9%) having more than 50% seizure reduction rates. At 6 months, half of the patients remained on KD, with 14(28%) seizure free and 22(44%) having more than 50% seizure reduction rates. At 12 months, 15 patients(34.9%) remained on KD, with 14(32.6%) having more than 90% seizure reduction rates. Seizure types, initial fasting and age at diet onset were not statistically related to the outcomes. There were a few complications during the diet. The most common reasons for discontinuing KD were ineffectiveness and poor tolerability. CONCLUSION: Ketogenic diet appears to be a relatively effective and safe treatment option for children with intractable epilepsies.
Child ; Diet ; Epilepsy* ; Fasting ; Humans ; Ketogenic Diet* ; Male ; Retrospective Studies ; Seizures ; Seoul

PURPOSE: Ketogenic diet(KD) is an alternative treatment for children with intractable seizures. This study was performed to evaluate the efficacy and tolerability of ketogenic diet METHODS: A retrospective study was performed for 57 patients(31 males, and 25 females), who were enrolled in a ketogenic diet program from 1998 to 2003 in Seoul National University Children's Hospital. We investigated the overall efficacy, influencing factors such as age at diet onset, seizure type, initial fasting, adverse events and reasons for discontinuing the diet. RESULTS: The patients mean age at diet onset was 3.5 years old. They had 3.14 medications on average at the diet initiation. One month after the diet initiation, 49 of 57(86 %) remained on KD, with 37(64.9%) having more than 50% seizure reduction rates. At 6 months, half of the patients remained on KD, with 14(28%) seizure free and 22(44%) having more than 50% seizure reduction rates. At 12 months, 15 patients(34.9%) remained on KD, with 14(32.6%) having more than 90% seizure reduction rates. Seizure types, initial fasting and age at diet onset were not statistically related to the outcomes. There were a few complications during the diet. The most common reasons for discontinuing KD were ineffectiveness and poor tolerability. CONCLUSION: Ketogenic diet appears to be a relatively effective and safe treatment option for children with intractable epilepsies.
Child ; Diet ; Epilepsy* ; Fasting ; Humans ; Ketogenic Diet* ; Male ; Retrospective Studies ; Seizures ; Seoul

A ketogenic diet (KD) is a dietary approach to treat intractable epilepsy. The KD begins with hospitalization and the child and their parents can adapt to the KD for 1-2 weeks. Recently, various type of dietary intervention such as the modified Atkins diet (MAD) and the low glycemic index treatment (LGIT) have been performed. Since 2010, we carried out the KD, MAD, and LGIT for total of 802 patients; 489 patients (61%) for the KD, 147 patients (18.3%) with the MAD, and 166 patients (20.7%) for the LGIT. In this report, application of these dietary practices in Severance Hospital is shared.
Child* ; Diet, Carbohydrate-Restricted ; Epilepsy* ; Glycemic Index ; Hospitalization ; Humans ; Ketogenic Diet* ; Meals* ; Parents