A recent study reveals that ketogenic diet or “keto diet” is safe and useful for treating infants with drug-resistant epilepsy.
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| Photo: 8-Month-Old Baby Eating Food | InStyleHealth |
What Is Drug-Resistant Epilepsy?
Drug-Resistant Epilepsy (DRE) is a medical term that
is used to describe when adequate trials of two anti-epileptic drugs (AEDs) failed
to control a person’s seizure events. Experts also refer to this condition as “intractable”,
“refractory” or “uncontrolled” epilepsy.
The drug-resistant epilepsy (DRE) takes place when a
person has failed to become seizure-free with adequate trials of two
anti-seizure medications or called ASMs.
ASMs or anti-seizure medications must be chosen appropriately
based on the person’s seizure type, tolerated by the person, and that have been
tried alone or together with other seizure medications.
Experts did search multiple online databases for
studies that provided seizure frequency data for infants aged <2 years who
received treatment with high-fat diet for >1 month. There were 33
studies covered in the meta-analysis, of which 2 were randomized controlled
trials and the rest were uncontrolled. There were 5 of these studies covered
exclusively infants, while 28 included infants as part of the wider cohort.
There were a total of 534 infants who had followed a
ketogenic diet for >1 month were covered, where 208 were from cohorts
including infants exclusively. There were 8 studies only involved those with infantile
spasms or West syndrome, and most studies covered patients with a range of
epilepsy syndromes. The average age at seizure onset was 4.1 months, and average
age at diet onset was 13.0 months. Average number of failed antiepileptic drugs
prior starting keto diet was 2.9.
Based on the collected data from the uncontrolled studies,
59% of infants attained >50% seizure reduction and 33% attained
seizure freedom. The retention rates differ between 84% at 3 months and 27% at
24 months.
Frequently reported side effects were dyslipidemia at 12%,
vomiting at 6%, constipation at 4%, gastroesophageal reflux at 4%, and diarrhea
at 4%.
These studies were categorized or stratified as low
quality. This requires a need for high-quality randomized controlled trials to
validate the effectiveness, safety, and tolerability of dietary treatment in the
vulnerable age group.
Source: Epilepsia 2020;doi:10.1111/epi.16543