Ketogenic diet reduces frequency of seizures at care center in China

Data from 288 children with Dravet syndrome, other disorders reviewed

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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The frequency of seizures decreased substantially for most children with medication-resistant epileptic disorders such as Dravet syndrome at a Chinese center after they were put on the ketogenic diet.

It was fairly common for the seizures to reappear after a few months, however.

“The findings suggest that the [ketogenic diet] can be an effective treatment for drug-resistant epilepsy, but that seizure recurrence is common,” the researchers wrote in “Long-term effectiveness and seizure recurrence risk factors of ketogenic diet for pediatric refractory epilepsy: Experience from a tertiary care center in China,” which was published in Epileptic Disorders.

In a ketogenic diet, very little carbohydrates and more fats are eaten, so the body burns fat for energy. This is mainly used to help reduce seizure frequency in children with epilepsy that’s hard to treat.

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Seizures and duration of ketogenic diet

The scientists reviewed data from 288 children with drug-resistant seizures who were given a ketogenic diet while being cared for at Children’s Hospital of Fudan University, China between 2011 and 2020. Thirty-four children had Dravet syndrome and the rest had other forms of epilepsy.

About half the children stuck with the ketogenic diet for at least a year and about one in three were still following it at two years. The most common reasons for stopping the diet were a lack of efficacy in the first year and an inability to stick with it.

After the first three months on the diet, 9.7% of patients were seizure-free, and another 46.5% were having less than half as many seizures as they had before starting the diet. Among the 234 patients who were on the diet at least six months, 16.7% were seizure-free in that time and 39.9% had a reduction in seizure frequency of at least 50%.

About one in eight (14.2%) patients on the diet for a full year were seizure-free the whole time and around one in three (30.2%) had about half as many seizures as before the diet. Of the 103 patients who were on the diet two years, 9% had no seizures and 20.5% had them less than half as frequently.

Among those with Dravet syndrome, about two-thirds on the ketogenic diet for at least six months had no seizures during that time, and slightly less than half of the Dravet patients on the diet for two years were seizure-free the whole time.

A handful of patients, including two with Dravet syndrome, had a minimal response to the diet, but “most patients showed reduced seizure frequencies compared to the baseline,” the researchers wrote.

In statistical models, the children with Dravet syndrome were more likely than those with other conditions to have seizures reoccur after a few months of being free of them. Those with abnormalities on brain electrical activity tests were also more likely to have seizures reappear after a period of being seizure-free. Patients who stopped the diet were more likely to see seizures return as well.

“Our findings also suggest that clinicians may want to consider extending the [ketogenic diet] maintenance treatment period as long as possible, and that they may want to monitor children with EEG [electroencephalogram] abnormalities for signs of seizure recurrence,” the scientists wrote. “[O]ur data will prove useful for both physicians and patients dealing with drug-resistant epilepsy who undergo [ketogenic diet] therapy.”

They said more studies to assess the long-term effects of the ketogenic diet in treatment-resistant epilepsy are needed.