Changes in growth and seizure reduction in children on the ketogenic diet as a treatment for intractable epilepsy

Abstract

Objective: To assess growth and seizure reduction in epileptic children using the ketogenic diet as a treatment for intractable epilepsy.

Design: A retrospective chart review was designed to evaluate urinary ketone levels, height and weight z scores and percentiles, and seizure reduction. Data were collected at baseline and at 6 and 12 months.

Subjects/settings: Fifty-seven subjects, ages 1 to 26 years old, started the ketogenic diet at Rush University Medical Center between August 1995 and December 2001. Thirty-nine subjects stayed on the diet for 6 months, and five more were lost by the 12th month of follow-up. Statistical analysis Mann-Whitney U tests assessed differences between male and female subjects and between subjects with high ketosis and moderate ketosis. Friedman tests followed by Wilcoxon sign rank tests assessed the significance of changes in growth at baseline and at 6 and 12 months. Associations between seizure reduction and growth and urinary ketone levels were determined using chi 2 tests. A binary logistic regression model identified potential predictors of growth and seizure reduction.

Results: Height-for-age z scores significantly decreased ( P < or =.0005) from -0.30+/-1.19 to -0.99+/-1.13 among subjects on the diet for 12 months. Subjects with high ketosis (80 to 160 mg/dL) experienced a significant decrease ( P < or =.0005) in height-for-age z scores from -0.45+/-1.28 to -1.1+/-1.23, whereas subjects with moderate ketosis did not. Observed percent seizure reduction was similar to those of other published studies.

Conclusions: Subjects on the ketogenic diet showed a delay in growth. More research is needed to evaluate the relationship between ketosis and growth.