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. 2019 Jun 19;9(1):8736.
doi: 10.1038/s41598-019-45147-6.

The ketogenic diet in children 3 years of age or younger: a 10-year single-center experience

Se Hee Kim  1   2 , Alexandra Shaw  1 , Robyn Blackford  3 , Wesley Lowman  3 , Linda C Laux  1 , John J Millichap  4 , Douglas R Nordli Jr  5
Affiliations

The ketogenic diet in children 3 years of age or younger: a 10-year single-center experience

Se Hee Kim et al. Sci Rep. .

Abstract

The ketogenic diet (KD) is an effective treatment option for intractable epilepsy. Here, we reviewed the last 10 years of our experience with the KD and characterized its use in patients under 3 years of age. Medical records of all patients under the age of 3 years who were treated with the ketogenic diet from April 2004 to June 2014 were retrospectively reviewed. One hundred and nine patients with drug-resistant epilepsy were included. The mean age at the initiation of the KD was 1.4 ± 0.8 years old. The youngest patient was 3 weeks old. After 3 months, 39% (42/109) of patients responded to the KD and experienced more than 50% seizure reduction. Of those 42 patients, 20 (18%) achieved complete seizure control. Patients with a genetic etiology showed a better response to the KD in seizure reduction than the other patients (p = 0.03). Age at initiation of the KD was not related to eventual seizure outcome (p = 0.6). The KD continues to be an effective, safe, and well tolerated treatment option for infants with intractable epilepsy.

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Conflict of interest statement

The study did not receive any corporate sponsorship, government, or institutional funding. Alexandra Shaw, Wesley Lowman and Linda C. Laux reports no disclosures. Se Hee Kim serves as a member of the ILAE commission on Medical Therapies. She is a principal investigator for research grants from Yonsei University College of Medicine. Se Hee Kim received funding as a co-investigator in NIH/NINDS R12NS106921. Robyn Blackford has received consultant fees from Nutricia North America and serves on the advisory board of Trumacro, unrelated to this study. John J. Millichap serves as an Associate Editor of Neurology® and Editor of Pediatric Neurology Briefs; volunteers on the medical advisory board of and received research funding from the Jack Pribaz Foundation (KCNQ2.org); received royalties for online monographs from Up-To-Date; served on the scientific advisory board and speaker’s bureau for Mallinkrodt, Esai, Biomarin; served as a speaker for Sunovion and Nutricia North America; consulted for UCB, Xenon, Upsher-Smith, and Ionis; is principal investigator for a clinical trial funded by UCB Pharma; and is the principal investigator for research grants from Citizens United for Research in Epilepsy (CURE); and is the site investigator for research grants from Pediatric Epilepsy Research Foundation (PERF) and NIH (1-U01-NS090407). Douglas R. Nordli Jr. received funding as a co-investigator in NIH/NINDS 1-RO1-NS43209 and he is an associate editor for UpToDate.

Figures

Figure 1
Figure 1
Chart showing the use of the KD in patients under 3 years old in each year (From April 2004 to June 2014). (N. of patients in each year).
Figure 2
Figure 2
Flow diagram.
See this image and copyright information in PMC

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