Efficacy and tolerability of the ketogenic diet versus high-dose adrenocorticotropic hormone for infantile spasms: A single-center parallel-cohort randomized controlled trial

Epilepsia
Anastasia DresslerMartha Feucht

Abstract

To compare the efficacy and safety of the ketogenic diet (KD) with standard adrenocorticotropic hormone (ACTH) treatment in infants with West syndrome. In this parallel-cohort (PC) randomized controlled trial (RCT), infants were randomly allocated to KD or high-dose ACTH. Those who could not be randomized were followed in a PC. Primary end point was electroclinical remission at day 28. Secondary end points were time to electroclinical remission, relapse after initial response, seizure freedom at last follow-up, adverse effects, and developmental progress. One hundred one infants were included: 32 in the RCT (16 KD; 16 ACTH) and 69 in the PC (37 KD; 32 ACTH). Electroclinical remission at day 28 was similar between KD and ACTH (RCT: 62% vs 69%; PC: 41% vs 38%; combined cohort: 47% vs 48%; KD vs ACTH, respectively). In the combined cohort, time to electroclinical remission was similar between both treatments (14 days for KD, 16 days for ACTH). However, relapse rates were 16% (KD) and 43% (ACTH, P = 0.09), and seizure freedom at last follow-up was 40% (KD) and 27% (ACTH, P = 0.18). Adverse effects needing acute medical intervention occurred more often with ACTH (30% with KD, 94% with ACTH, P < 0.001). Age-appropriate psychomotor de...Continue Reading

References

Aug 1, 1983·Neurology·O C SneadG J Myers
Oct 1, 1983·The Journal of Pediatrics·R A HrachovyT E Zion
Nov 10, 2001·Brain & Development·P CuratoloR Bombardieri
May 3, 2002·Pediatrics·Eric H KossoffJohn M Freeman
Jan 22, 2004·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Richard A Hrachovy, James D Frost
May 16, 2006·Brain & Development·So Hee EunHeung Dong Kim
May 14, 2009·Epilepsy & Behavior : E&B·Eric H KossoffEileen P G Vining
Jun 25, 2009·Developmental Medicine and Child Neurology·Mijna Hadders-AlgraKarin J Middelburg
May 12, 2010·Archives of Disease in Childhood·Katrina DarkeUNKNOWN trial steering committee on behalf of participating investigators
Jul 6, 2010·Seizure : the Journal of the British Epilepsy Association·Anastasia DresslerMartha Feucht
Jul 9, 2010·Epilepsia·John M PellockJames W Wheless
Apr 22, 2011·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Sergiusz JóźwiakMaria Respondek-Liberska
Jul 23, 2013·Brain & Development·Joon Won KangHeung Dong Kim
Jan 18, 2014·Pediatric Neurology·Husam R KayyaliAhmad Abdelmoity
Feb 25, 2014·Brain & Development·Yoshiko HiranoMakiko Osawa
Mar 7, 2014·Brain : a Journal of Neurology·Eric T PayneCecil D Hahn
Jun 19, 2014·Seizure : the Journal of the British Epilepsy Association·Keitaro YamadaYasuhiro Suzuki
Aug 26, 2014·Developmental Medicine and Child Neurology·Raili RiikonenIiris Sorri
Sep 12, 2015·Epilepsy Research·Anastasia DresslerMartha Feucht
Sep 13, 2016·Epilepsia·Kelly G KnuppUNKNOWN Pediatric Epilepsy Research Consortium

❮ Previous
Next ❯

Citations

Nov 27, 2019·Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine·Anastasia DresslerAndreas Repa
Dec 4, 2019·Epilepsy Currents·Eric Kossoff, Mackenzie Cervenka
Jun 20, 2020·Indian Journal of Pediatrics·Saurabh S Chopra
Jan 16, 2020·Children·Remi JanicotCarl E Stafstrom
Aug 8, 2020·Nordic Journal of Psychiatry·Magnus G ChristensenAnders Fink-Jensen
Apr 23, 2020·Expert Review of Neurotherapeutics·Nicola SpecchioPaolo Curatolo
Sep 3, 2020·Nutrients·Alberto VerrottiGiovanni Farello
Oct 27, 2020·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Emine TekinHaydar Ali Taşdemir
Feb 26, 2021·Journal of Nutrition and Metabolism·D HettiarachchiV H W Dissanayake
Sep 29, 2020·Epilepsy Research·Sookyong KohStéphane Auvin
Jun 9, 2020·Seizure : the Journal of the British Epilepsy Association·Anastasia DresslerChristoph Male
Jan 15, 2022·European Journal of Clinical Nutrition·Yue RuanLin Han

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.