Ketogenic diet treatment of children in the intensive care unit: Safety, tolerability, and effectiveness.

Seizure : the Journal of the British Epilepsy Association
Lila T WordenA G C Bergqvist

Abstract

The ketogenic diet (KD) is initiated emergently in the intensive care unit (ICU) for patients with super refractory status epilepticus (SRSE) and epileptic encephalopathies (EE). However, few data are available regarding safety, effectiveness, and long-term outcomes. We performed a retrospective cohort study of consecutive patients with KD initiated in the ICU from 2010 to 2018 for SRSE and EE. We characterized time to ketosis, adverse effects, and seizure outcomes. Responders were defined as having ≥50 % reduction in seizure frequency compared to prior to KD initiation. We identified 29 patients. KD was initiated for SRSE in 12 patients, EE in 8 patients, and EE with SRSE in 9 patients. KD was initiated after a median of 9 days. Ketosis was achieved 2 days faster in fasted patients (p < 0.0001). All patients had at least 1 KD-related adverse effect, most often hypoglycemia, constipation, or acidosis. There was ≥50 % reduction in seizure frequency compared to prior to KD initiation by 1 week in 17/28 patients, seizure-freedom by 2 weeks in 7/28 patients, and weaned off anesthetics in 11/17 patients. All KD-responders at 1 month had continued response at 6 months. Mortality at 1 year was 24 %. There was no difference in KD respo...Continue Reading

References

Mar 7, 2002·Epilepsia·M SahinJ J Riviello
Jun 24, 2003·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·L Lion FrançoisM David
Aug 26, 2004·Neuropediatrics·F A M BaumeisterJ Peters
Aug 12, 2006·Journal of Child Neurology·C Beth HendersonDeirdre A Caplin
Jul 11, 2007·Journal of Child Neurology·Amitha SampathEileen P G Vining
May 6, 2008·Lancet Neurology·Elizabeth G NealJ Helen Cross
Dec 8, 2009·Seizure : the Journal of the British Epilepsy Association·Renske van DelftMarian Majoie
May 7, 2013·Seizure : the Journal of the British Epilepsy Association·Roberto H CaraballoRicardo Cersosimo
Nov 30, 2013·Pediatric Neurology·Sunila E O'ConnorBeth Zupec-Kania
Jul 12, 2014·Seizure : the Journal of the British Epilepsy Association·Roberto Horacio CaraballoNidia Escobal
Dec 3, 2014·Epilepsy Research·Roberto Horacio CaraballoNidia Escobal
Jun 9, 2015·Pediatrics and Neonatology·Eva Lai-Wah FungPhyllis Yin-Ping Yau
Apr 28, 2016·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Martha SpiliotiAthanasios Evangeliou
Aug 1, 2016·Seizure : the Journal of the British Epilepsy Association·Brian AppavuRanda Jarrar
Feb 10, 2017·Neurology·Mackenzie C CervenkaRomergryko G Geocadin
Mar 10, 2017·Epilepsia·Robert S FisherSameer M Zuberi
Mar 29, 2018·Epilepsia Open·Anastasia DresslerMartha Feucht
May 5, 2018·Epilepsy Research·Ravindra AryaUNKNOWN pediatric Status Epilepticus Research Group (pSERG)
Jun 10, 2018·Seizure : the Journal of the British Epilepsy Association·Marina Gaínza-LeinAdam P Ostendorf
Aug 15, 2018·Archives of Disease in Childhood·Petros Fessas, Amedine Duret
Oct 3, 2018·Seizure : the Journal of the British Epilepsy Association·Kevin Gurcharran, Zachary M Grinspan

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