| Efficacy of the ketogenic diet: Which epilepsies respond? | |
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MedLine Citation:
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PMID: 22310062 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We report the efficacy of the ketogenic diet in refractory epilepsies focusing on outcomes with regard to epilepsy syndromes and etiology in children and adults with refractory epilepsy. Sixty-four consecutive children and four adults were prospectively enrolled from 2002 to 2009; seven were excluded from analysis. The classical ketogenic diet was initiated on an inpatient basis with dietary ratios ranging from 2:1 to 4:1 fat to carbohydrate and protein. Patients were classified according to syndrome and etiology using the 1989 and more recent 2010 International League Against Epilepsy (ILAE) classification systems. Responders were defined as >50% reduction in seizure frequency compared to baseline. Syndromes included symptomatic generalized (52), genetic (idiopathic) generalized (7), and focal epilepsies (2) and etiologies included structural (24), genetic (18), and unknown (19). Twenty-nine (48%) of 61 patients were responders at 3 months. Two children became seizure-free: one with focal epilepsy of unknown etiology and another with refractory childhood absence epilepsy. Responsive syndromes included migrating partial epilepsy of infancy, childhood absence epilepsy, focal epilepsy, epilepsy with myoclonic-atonic seizures, and Dravet syndrome. Children with lissencephaly and hypoxic ischemic encephalopathy had surprisingly good responses. The ketogenic diet is an effective treatment for children and adults with refractory epilepsy. The response is predicted by type of epilepsy syndrome. Accurate characterization of the electroclinical syndrome is an important factor in decisions about timing of initiation of the ketogenic diet. |
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Authors:
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Sasipa Thammongkol; Danya F Vears; Jillian Bicknell-Royle; Judy Nation; Kellie Draffin; Karen G Stewart; Ingrid E Scheffer; Mark T Mackay |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-6 |
Journal Detail:
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Title: Epilepsia Volume: - ISSN: 1528-1167 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-7 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 2983306R Medline TA: Epilepsia Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Wiley Periodicals, Inc. © 2012 International League Against Epilepsy. |
Affiliation:
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Children's Neuroscience Centre, Royal Children's Hospital, Parkville, Victoria, Australia Pediatric Neurology Department, Prasat Neurological Institute, Bangkok, Thailand Epilepsy Research Centre, Department of Medicine, The University of Melbourne, Austin Health, West Heidelberg, Victoria, Australia Department of Nutrition and Dietetics, Royal Children's Hospital, Parkville, Victoria, Australia Department of Nutrition and Dietetics, Austin Health, West Heidelberg, Victoria, Australia Department of Paediatrics, Austin Health, West Heidelberg, Victoria, Australia Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia Florey Neuroscience Institutes, Melbourne, Victoria, Australia Murdoch Childrens Research Institute, Parkville, Victoria, Australia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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