Assessment of serum biochemistry, nutritional status and adverse effects of children with refractory epilepsy using the ketogenic diet
Keywords:
child, diet, effects, epilepsy, dietary fatsAbstract
Objective
The purpose of this research was to evaluate adverse events, serum biochemistry, growth and nutritional status of children with difficult-to-control seizures who were submitted to ketogenic diet.
Methods
Twenty-three patients aging from 2 to 17 years with refractory epilepsies, where 43.5% (n=10) were males and
56.5% (n=13) females from the Sector of Neuropediatrics, Discipline of Neurology of the Universidade Federal
de São Paulo, were treated with the ketogenic diet and followed up for at least 1 year. Two patients were not
able to achieve persistent ketosis either because they rejected the diets or their parents did not comply.
Results
Adverse events were all reversible and included hyperlipidemia, constipation (17.4%), nausea and vomiting (43.4%), drowsiness (47.8%), intercurrent infections (3.0%), diet refusal (13.0%) and epistaxis (4.3%). Growth
was not affected in the short term and most heights remained within the normal centile lines.
Conclusion
The ketogenic diet can be considered a safe and effective treatment for children with intractable seizures.
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References
Galván-Manso M, Arellano M, Sans A, Sanmarti FX, Gómez L. Dieta cetogénica: una alternativa válida en epilepsias refractarias. Rev Neurol. 2001; 33(11):1010-4.
Stafstrom C, Spencer S. The ketogenic diet: a therapy in search of an explanation. Neurology. 2000; 54(2):282-3.
Nordli DR. The ketogenic diet. Uses and abuses. Neurology. 2002; 58(Suppl 7):S21-4.
Cuéllar R, Molinero M. Tratamiento de los niños com epilepsia de difícil control. Rev Neurol. 2003; 37(4):371-5.
Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia. 1981; 22(4):489-501.
Freeman JM, Kelly MT, Freeman JB. The epilepsy diet treatment. An introduction to The Ketogenic Diet. New York: Demos Vermande; 1996. p.24-7.
Huttenlocher PR. Ketonaemia and seizures: metabolic and anticonvulsant effects of the two ketogenic diets in childhood epilepsy. Pediatr Res. 1976; 10(5):536-40.
Freeman J, Veggiotti P, Lanzi G, Tagliabue A, Perucca E. The ketogenic diet: from molecular mechanisms to clinical effects. Epilepsy Res. 2006; 68(2): 145-80.
Forcadas-Berdusán MI. Indicaciones y resultados de los tratamientos no farmacológicos de las epilepsias: estimulación vagal, dieta cetógena y rayos gamma. Rev Neurol. 2002; 35(Supl 1): S144-50.
Kielb S, Koo HP, Bloom DA, Faerber GJ. Nephrolithiasis associated with the ketogenic diet. J Urol. 2000; 164(2):464-6.
Freitas A, Valente KD, Casella EB, Paz JÁ, Marques-Dias MJ. Ketogenic diet: ten year experience in children. J Epilepsy Clin Neurophysiol. 2002; 8(2):91.
Hemingway C, Freeman JM, Pillas DJ, Pyzik PL. The ketogenic diet: A 3- to 6- year follow-up of 150 children enrolled prospectively. Pediatrics. 2001; 108(4):898-905.
Kossoff EH, Pyzik PL, Furth SL, Hladkly HD, Freeman JM, Vining EPG. Kidney stones, carbonic anhydrase inhibitors, and the ketogenic diet. Epilepsia. 2002; 43(10):1168-71.
Panico LR, Demartini MG, Rios VG, Carniello MA. Dieta cetogénica en la epilepsia refractaria infantil: respuesta electroclínica, complicaciones y efectos secundarios. Rev Neurol. 2000; 31(3):212-20.
Marsh EB, Freeman JM, Kossoff EH, Vining EPG, Rubenstein JE, Pyzik PL, et al. The outcome of children with intractable seizures: a 3- to 6- year follow-up of 67 children who remained on the ketogenic diet less than one year. Epilepsia. 2006; 47(2):425-30.
Rios VG, Panico LR, Demartini MG, Carniello MA. Complicaciones en el tratamiento de la epilepsia con dieta cetogênica. Rev Neurol. 2001; 33(10): 909-15.
Rubenstein JE, Kossoff EH, Pyzik PL, Vining EPG, McGrogan JR, Freeman JM. Experience in the use of the ketogenic diet as early therapy. J Child Neurol. 2005; 20(1):31-4.
Berry-Kravis E, Booth G, Taylor A, Valentino LA. Bruising and the ketogenic diet: Evidence for diet-induced changes in platelet function. Ann Neurol. 2001; 49(1):98-103.
Nordli DR, Kuroda MM, Carrol J, et al. Experience with the ketogenic diet in infants. Pediatrics. 2001; 108(1):129-33.
Vining EPG, Pyzik P, McGrogan J, Hladky H, Anand A, Kriegler S, et al. Growth of children on the ketogenic diet. Dev Med Child Neurol. 2002; 44(12):796-802.
Peterson SJ, Tangney CC, Pimentel-Zablah EM, Hjelmgren B, Booth G, Berry-Kravis E. Changes in growth and seizure reduction in children on the ketogenic diet as a treatment for intractable epilepsy. J Am Diet Assoc. 2005; 105(5):718-25.
Thiele EA. Assessing the efficacy of antiepileptic treatments: The ketogenic diet. Epilepsia. 2003; 44(Suppl 7):26-9.
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Copyright (c) 2023 Sueli RIZZUTTI, Ana Maria Figueiredo RAMOS, Isa de Pádua CINTRA, Mauro MUSZKAT, Alberto Alain GABBAI
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