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Ketogenic diet: experience in the management of patients with drug-resistant epilepsy Ketogenic Diet: a Forgotten Alternative
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Abstract
The ketogenic diet (KD) has been a non-pharmacological treatment alternative for drug-resistant epilepsy since the 1920s. The aim of this study was to evaluate the effectiveness of the KD in controlling convulsive episodes and its impact on the reduction of antiepileptic drugs, as well as to describe the most frequent adverse effects. An observational, descriptive, retrospective, and analytical single-center study was conducted from January 2016 to December 2020. The overall effectiveness of the KD was similar to that reported in the literature: 28.5 % of patients became seizure-free, and 78.6 % had a reduction greater than 50 % in seizure frequency. The ANOVA test was significant at 6 and 12 months (p = 0.05 and 0.008, respectively). A reduction of 1.23 medications per patient was observed after 12 months of treatment. Most parents reported improvements in seizure frequency and in their children's behavior and function, particularly regarding activity level and alertness. The diet was generally well tolerated, and 92.8 % of patients maintained adequate growth parameters. Adverse effects, all reversible, included gastroesophageal reflux (35.7 %), irritability (14.3 %), hypercholesterolemia and hypertriglyceridemia (14.3 %), and renal tubular acidosis (7.1 %). The ketogenic diet is a safe and effective non-pharmacological alternative for managing drug-resistant epilepsy in children. Its implementation should be based on an individualized benefit-risk assessment and always involve a multidisciplinary team.
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