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(Abst. 2.293), 2011

The Ketogenic Diet Efficacy in Generalized vs Focal Epilepsy
Authors: H. Kayyali, M. Gustafson, V. Driscoll, M. Williams, A. Abdelmoity
Content: Rationale: The ketogenic diet has been proven to be an effective modality in the treatment of intractable epilepsy. Some studies suggested that the ketogenic diet is possibly more effective in generalized epilepsy than focal epilepsy. This study aims to assess the ketogenic diet efficacy and quality of life improvement in relation to epilepsy type (generalized vs focal). The results may enhance our understanding of the indications of the ketogenic diet in the treatment of epilepsy.Methods: We conducted a retrospective chart review of all patients who received ketogenic diet therapy from April of 2005 through May 2011 in the Pediatric Neurology Program at Children s Mercy Hospital (N=72) with an age ranging between 4 months, and 17 years at the time of diet initiation. Ketogenic diet ratio ranged between 1:1 to 4:1 fat to protein and carbohydrate. Seizure control and quality of life improvement were assessed at 3 months, 6 months and 12 months after starting the diet. The assessment was based on family reports during follow up clinic visits, and phone interviews.Results: Out of 72 patients involved in the study, 34 (47%) had generalized epilepsy. Three months after starting the diet, 83% of the patients with generalized epilepsy had >50% seizure reduction versus 59% in the focal epilepsy group (p=0.027). 53 patients were assessed at 6 months. 27 (51%) of them had generalized epilepsy. 73% of those with focal epilepsy experienced significant seizure improvement and reported improvement of quality of life compared to 66% in the generalized epilepsy group(p=0.611). At 12 months, 73% of the patients with generalized epilepsy reported >50% seizure reduction. Similar rate was found in the focal epilepsy group (p=0.845). However, the quality of life improved in 86% of generalized epilepsy patients compared to 76% in the focal epilepsy patients (p=0.174).Conclusions: We found no significant differences in the ketogenic diet efficacy between generalized epilepsy patients and focal epilepsy patients. However, quality of life seems slightly better in the generalized epilepsy patients after one year of being on the diet.