1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-7-03-a 10.15844/pedneurbriefs-7-1-4 Seizure Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Ketogenic Diet for Intractable Seizures http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 01 1993 01 07 2016 7 1 3 3 Copyright: © 1993 The Author(s) 1993 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Efficacy of the ketogenic diet for intractable seizure disorders: review of 58 cases

The efficacy of the ketogenic diet in 58 children with multiple seizure types resistant to antiepileptic drugs has been evaluated at the Johns Hopkins University School of Medicine, Baltimore.

 Antiepileptic Drugs Mental Retardation Lennox-Gastaut Pattern

The efficacy of the ketogenic diet in 58 children with multiple seizure types resistant to antiepileptic drugs has been evaluated at the Johns Hopkins University School of Medicine, Baltimore. All patients had severe neurologic handicaps: mental retardation (84%), cerebral palsy (45%), and microcephaly (15%). Mean age at diet initiation was 60 months (range 12-235 months). EEGs showed Lennox-Gastaut pattern (33%), hypsarrhythmia (19%), and focal activity (14%). Antiepileptic drugs, including valproate, showed no adverse interaction. Seizures were completely controlled in 29%, and reduced by half in 38%. Diet was continued for an average of 24 months in those controlled and for 4 months in the unimproved group. Dietary benefit was not determined by seizure type. Renal stones required withdrawal of the diet in 2 patients. [1]

COMMENT. Despite further demonstration of its efficacy and relative safety, the ketogenic diet is not a popular method of therapy among neurologists generally. Apart from the Mayo Clinic and Johns Hopkins, the diet is not frequently promoted in the training of pediatric neurologists and dieticians. Furthermore, the bias against fat in the diet in today’s society adds to the difficulty in convincing mothers to become enthusiastic partners in the treatment program. Millichap JG at the Mayo Clinic [2] and Schwartz RM at the John Radcliffe Hospital, Oxford [3] studied the metabolic effects of the diet and were unable to document any significant changes in blood lipid profiles using the classical diet. For an account of the mechanism of action of the diet, see Millichap JG. Progress in Pediatric Neurology, Chicago, PNB Publ, 1991, p 87-88.

 Kinsman SL Vining EP Quaskey SA Mellits D Freeman JM Efficacy of the ketogenic diet for intractable seizure disorders: review of 58 cases Epilepsia 1992 Nov-Dec 33 6 1132 6 10.1111/j.1528-1157.1992.tb01770.x 1464275 Millichap JG Jones JD Acid-base, Electrolyte, and Amino-acid metabolism in children with petit mal. Etiologic significance and modification by anticonvulsant drugs and the ketogenic diet Epilepsia 1964 Sep 5 239 55 14232248 Schwartz RH Eaton J Bower BD Aynsley-Green A Ketogenic diets in the treatment of epilepsy: short-term clinical effects Dev Med Child Neurol 1989 Apr 31 2 145 51 10.1111/j.1469-8749.1989.tb03972.x 2786822