La dieta chetogena nelle epilessie farmacoresistenti

In this collaborative trial from three italian groups of Child Neuropsychiatry, classical (4:1) ketogenic diet has been evalued as add-on treatment in 41 refractory epilepsy patients, aged 1-18 years. Diagnoses were: partial or generalized crypto/symptomatic epilepsy, severe myoclonic epilepsy in infancy and ESES. Child neuropsychiatrists collaborated with dieticians to carry out sample's selection and patient'management. During treatment, seizure frequency, side effects, ketonuria, blood ketone levels and other parameters were evalued. A seizure decrease of more than 50% was obtained in 31% of patients at three months from starting diet: 6 (symptomatic partial epilepsies), 1 (cryptogenic partial epilepsy), 6 (generalized symptomatic epilepsies) one (cryptogenic generalized epilepsy). One year follow up showed only three responders (7%). It is noteworth that the predominant epilepsy etiology of responders was hypoxic-ischaemic insult, in partial epilepsies, and disorder of migration (pachygyria) in generalizd epilepsies.