TY - JOUR
T1 - Ketogenic diet use in children with intractable epilepsy secondary to malformations of cortical development
T2 - A two- centre experience
AU - Pasca, Ludovica
AU - Caraballo, Roberto H.
AU - De Giorgis, Valentina
AU - Reyes, J. Gabriela
AU - Macasaet, Joyce A.
AU - Masnada, Silvia
AU - Armeno, Marisa
AU - Musicco, Massimo
AU - Tagliabue, Anna
AU - Veggiotti, Pierangelo
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Purpose: To evaluate the efficacy and tolerability of the ketogenic diet (KD) as a treatment for drug-resistant epilepsy secondary to malformations of cortical development. Methods: A two-centre retrospective analysis of 45 paediatric patients with refractory epilepsy due to malformation of cortical development was carried out. Patients were divided into three groups based on malformation type: abnormal neural proliferation (Group 1); abnormal neural migration (Group 2) and abnormal post-migrational development (Group 3). The efficacy of the KD was assessed in terms of seizure frequency reduction. We identified the proportion of patients achieving > 50% seizure frequency reduction overall and in the three subgroups. Results: The adherence to KD was variable. KD was pursued from a minimum of 4 months to a maximum of 96 months. 20 patients (44%) obtained a seizure reduction of > 50% and 2 patients became seizure free. >50% seizure reduction was most commonly achieved by patients in group 3 (64.7%) than in groups 2 (31.8%) and 1 (33.3%). Conclusions: The best response was observed in patients with malformations of post migrational development. Considering its tolerability, the use of KD should be considered in patients with drug-resistant epilepsy secondary to malformations of cortical development when surgery is not a viable option.
AB - Purpose: To evaluate the efficacy and tolerability of the ketogenic diet (KD) as a treatment for drug-resistant epilepsy secondary to malformations of cortical development. Methods: A two-centre retrospective analysis of 45 paediatric patients with refractory epilepsy due to malformation of cortical development was carried out. Patients were divided into three groups based on malformation type: abnormal neural proliferation (Group 1); abnormal neural migration (Group 2) and abnormal post-migrational development (Group 3). The efficacy of the KD was assessed in terms of seizure frequency reduction. We identified the proportion of patients achieving > 50% seizure frequency reduction overall and in the three subgroups. Results: The adherence to KD was variable. KD was pursued from a minimum of 4 months to a maximum of 96 months. 20 patients (44%) obtained a seizure reduction of > 50% and 2 patients became seizure free. >50% seizure reduction was most commonly achieved by patients in group 3 (64.7%) than in groups 2 (31.8%) and 1 (33.3%). Conclusions: The best response was observed in patients with malformations of post migrational development. Considering its tolerability, the use of KD should be considered in patients with drug-resistant epilepsy secondary to malformations of cortical development when surgery is not a viable option.
KW - Cortical malformation
KW - Drug resistant epilepsy
KW - ESES
KW - Ketogenic diet
KW - Pediatric
KW - Polymicrogyria
KW - Seizure freedom
KW - Tolerability
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U2 - 10.1016/j.seizure.2018.03.005
DO - 10.1016/j.seizure.2018.03.005
M3 - Article
AN - SCOPUS:85044148986
VL - 57
SP - 34
EP - 37
JO - Seizure : the journal of the British Epilepsy Association
JF - Seizure : the journal of the British Epilepsy Association
SN - 1059-1311
ER -