Efficacy and long-term retention rate comparision of ketogenic diet (KD) for children with intractable epilepsy in outpatient department and inpatient department_Journal of Epilepsy

Authors：

YANGMaolin ¹ , CHENShuang ¹ , ZHAOCongmin ² ,  XIAONong ¹

1. Department of Children Rehabilitation, Children's Hospital of Chongqing Medical University, Key Laboratory of Development Disease in Chongqing, China International Science and Technology Cooperation base of Child development and Critical Disorders Key Laboratory of Developmental Diseases in Childhood Ministry of Education, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders. Chongqing 400014, China;
2. Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China;

Corresponding author：

XIAONong, Email: xiaonongwl@163.com

Keywords：

Children; Intractable epilepsy; Ketogenic diet; Outpatient; Inpatient; Efficacy; Long-term retention rate

DOI：

10.7507/2096-0247.20170006

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Objective To compare the efficacy and compliance of children children with refractory epilepsy receiving ketogenic diet (KD) in outpatient department with children receiving KD treatment in inpatient department. Methods A retrospective study of 44 children with intractable epilepsy receiving the modified classical ketogenic diets in outpatient department from June 2014 to December 2015, who were followed-up during the third, sixth and twelfth month. Records of epileptic seizures and adverse reactions were used to evaluate the efficacy and retention rate of inpatient department KD treatment in children with refractory epilepsy, and compared with 104 children receiving KD treatment in inpatient department at the same period. Results Thirty-four of the forty-four children comleted observation after 12-month follow-up, 15 cases had been seizure freedom, 22 cases had more than 50% reduction in seizure frequency, 12 patients had less than 50% reduction in seizure frequency.The total effective rate of the KD therapy in outpatient department was 64.7%, and the retention rate was 71%. 18 of of the 104 children with KD treatment in inpatient department at the same period comleted observation after 12-month follow-up, 3 cases had been seizure freedom, 5 cases had more than 50% reduction in seizure frequency, 13 cases had less than 50% reduction in seizure frequency.The total effective rate of the KD therapy in inpatient department was 27.8%, and the retention rate was 17.3%. Conclusion The KD therapy in outpatient department is effective to children with intractable epilepsy, and there is a highly efficacy and compliance of children receiving KD in outpatient department comparing with children receiving KD in inpatient department. Therefore, it's optional to children with refractory epilepsy who can't received KD by inpatient department because of insufficient number of beds.

Citation： YANGMaolin, CHENShuang, ZHAOCongmin, XIAONong. Efficacy and long-term retention rate comparision of ketogenic diet (KD) for children with intractable epilepsy in outpatient department and inpatient department. Journal of Epilepsy, 2017, 3(1): 39-43. doi: 10.7507/2096-0247.20170006 Copy

1.	Farrell K, Wirrell E, Whiting S. The definition and prediction of intractable epilepsy in children. Adv Nurol, 2006, 97(e11):435-442.
2.	Zupec-Kania BA, Spellman E. An overview of the ketogenic diet for pediatric epilepsy. Nutr Clin Pract, 2008, 23(6):589-596.
3.	Wheless JW. History of the ketogenic diet. Epilepsia, 2008, 49(Suppl 8):3-5.
4.	Cinthya Wibisono. Ten-year single-center experience of the ketogenic diet:factors influencing efficacy, tolerability, and compliance. J Pediatr, 2015, 166(12):1030-1036.
5.	Roberto A, Horacio M, Caraballo N. Ketogenic diet in pediatric patients withrefractory focal status epilepticus. Epilepsy Research, 2014, 108(3):1912-1916.
6.	Pires AJ, Elles van der, Louw E. Ketogenic diet guidelines for infants with refractory epilepsy. European Journal of Paediatric Neurology, 2015, 31(6):511-512.
7.	EH Kossoff, Elles van der, Louw E, et al. Ketogenic diet guidelines for infants with refractory epilepsy. European Journal of Paediatric Neurology, 2016, 32(1):798-809.
8.	Pires ME. Ketogenic diet for infantile spasms refractory to first-line treatments:an open prospective study. Epilepsy Res, 2013, 105(1e2):189e94.
9.	Eun SHl. Ketogenic diet for treatment of infantile spasms. Brain Dev, 2006, 28(9):566e71.
10.	Kossoff EH. When do seizures usually improve with the ketogenic diet?. Epilepsia, 2008, 49(2):329-333.
11.	邓宇虹, 周锦华, 黎冰梅.添加生酮饮食治疗难治性癫痫的长期保留率和不良反应.肠外与肠内营养, 2012, 19(6):1007.
12.	Jainn-Jim Lin, MD. Intravenous ketogenic diet therapy for treatment of the acute, stage of super-refractory status epilepticus in a pediatric patient. Pediatric Neurology, 2015, 52(5):442-445.
13.	Eva Lai, Wah Fung. Ketogenic diet as a therapeutic option in super-refractory status epilepticus. Pediatrics & Neonatology, 2015, 52(6):429-431.
14.	Shaun A. Limited efficacy of the ketogenic diet in the treatment of highly refractory epileptic spasms. Seizure, 2016, 35(6):59-64.
15.	Giangennaro Coppola. The effects of the ketogenic diet in refractory partial seizures with reference to tuberous sclerosis. European Journal of Paediatric Neurology, 2006, 22(2):148-151.
16.	廖建湘, 路新国, 操德智.生酮饮食疗法在难治性癫痫中的应用.中国实用儿科杂志, 2016, 31(1):11-15.
17.	朱登纳, 谢蒙蒙, 王俊辉.生酮饮食添加治疗儿童难治性癫痫的前瞻性研究.中国当代儿科杂志, 2014, 16(5):513-517.
18.	张晶卉, 孙若鹏.生酮饮食治疗难治性癫痫对儿童生长影响的研究现状.中国实用儿科杂志, 2008, 23(12):48-53.
19.	操德智, 路新国, 廖建湘.生酮饮食治疗难治性癫的初步观察.实用儿科临床杂志, 2007, 22(4):103-115.

1. Farrell K, Wirrell E, Whiting S. The definition and prediction of intractable epilepsy in children. Adv Nurol, 2006, 97(e11):435-442.
2. Zupec-Kania BA, Spellman E. An overview of the ketogenic diet for pediatric epilepsy. Nutr Clin Pract, 2008, 23(6):589-596.
3. Wheless JW. History of the ketogenic diet. Epilepsia, 2008, 49(Suppl 8):3-5.
4. Cinthya Wibisono. Ten-year single-center experience of the ketogenic diet:factors influencing efficacy, tolerability, and compliance. J Pediatr, 2015, 166(12):1030-1036.
5. Roberto A, Horacio M, Caraballo N. Ketogenic diet in pediatric patients withrefractory focal status epilepticus. Epilepsy Research, 2014, 108(3):1912-1916.
6. Pires AJ, Elles van der, Louw E. Ketogenic diet guidelines for infants with refractory epilepsy. European Journal of Paediatric Neurology, 2015, 31(6):511-512.
7. EH Kossoff, Elles van der, Louw E, et al. Ketogenic diet guidelines for infants with refractory epilepsy. European Journal of Paediatric Neurology, 2016, 32(1):798-809.
8. Pires ME. Ketogenic diet for infantile spasms refractory to first-line treatments:an open prospective study. Epilepsy Res, 2013, 105(1e2):189e94.
9. Eun SHl. Ketogenic diet for treatment of infantile spasms. Brain Dev, 2006, 28(9):566e71.
10. Kossoff EH. When do seizures usually improve with the ketogenic diet?. Epilepsia, 2008, 49(2):329-333.
11. 邓宇虹, 周锦华, 黎冰梅.添加生酮饮食治疗难治性癫痫的长期保留率和不良反应.肠外与肠内营养, 2012, 19(6):1007.
12. Jainn-Jim Lin, MD. Intravenous ketogenic diet therapy for treatment of the acute, stage of super-refractory status epilepticus in a pediatric patient. Pediatric Neurology, 2015, 52(5):442-445.
13. Eva Lai, Wah Fung. Ketogenic diet as a therapeutic option in super-refractory status epilepticus. Pediatrics & Neonatology, 2015, 52(6):429-431.
14. Shaun A. Limited efficacy of the ketogenic diet in the treatment of highly refractory epileptic spasms. Seizure, 2016, 35(6):59-64.
15. Giangennaro Coppola. The effects of the ketogenic diet in refractory partial seizures with reference to tuberous sclerosis. European Journal of Paediatric Neurology, 2006, 22(2):148-151.
16. 廖建湘, 路新国, 操德智.生酮饮食疗法在难治性癫痫中的应用.中国实用儿科杂志, 2016, 31(1):11-15.
17. 朱登纳, 谢蒙蒙, 王俊辉.生酮饮食添加治疗儿童难治性癫痫的前瞻性研究.中国当代儿科杂志, 2014, 16(5):513-517.
18. 张晶卉, 孙若鹏.生酮饮食治疗难治性癫痫对儿童生长影响的研究现状.中国实用儿科杂志, 2008, 23(12):48-53.
19. 操德智, 路新国, 廖建湘.生酮饮食治疗难治性癫的初步观察.实用儿科临床杂志, 2007, 22(4):103-115.

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Efficacy and long-term retention rate comparision of ketogenic diet (KD) for children with intractable epilepsy in outpatient department and inpatient department

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