Korean J Pediatr.  2006 Feb;49(2):187-191. 10.3345/kjp.2006.49.2.187.

The efficacy of ketogenic diet in childhood intractable epilepsy with malformation of cortical development

• Lee YM
• Kang DC
• Chung DE
• Kang HC
• Kim HD

• KMID: 1966612
• DOI: http://doi.org/10.3345/kjp.2006.49.2.187

Abstract

PURPOSE: Malformation of cortical development(MCD) constitutes an important etiology of intractable epilepsy and is considered an indication for surgical treatments, though their efficacy is limited and variable depending on MCD's location or distribution. Ketogenic diets are widely known to be effective, but as little study has been made concerning their efficacy on epilepsy with MCD, we evaluated the efficacy of ketogenic diets on MCD patients compared with that of epileptic surgery, which is more invasive.
METHODS
We performed retrospective studies and analyse on 30 patients with MCD diagnosed by brain MRI and treated with ketogenic diets for intractable epilepsy since 1998, checking decreases in their seizure episodes after starting the diets.
RESULTS
Cortical dysplasia was observed in 24(80.0 percent) patients as the most common type of MCD. Also, MCD was observed in unilateral hemisphere most commonly, in 23(76.7 percent) patients; it was observed in both hemispheres in 7(23.3 percent) patients. Nine(30.0 percent) out of 30 patients became seizure-free after starting ketogenic diets, and 14(46.7 percent) patients experienced 50 percent seizure reductions as well. Age of starting the diet or the duration of epilepsy period before starting showed no statistical relationship with the efficacy of the diet. Though the younger the patient and the longer the treatment the more effective the diet seemed to be, there was no statistical correlation between them. The location of MCD showed no significance neither.
CONCLUSION
Considering various limits and invasiveness of surgical treatment, a ketogenic diet could be a good tool in treating children with intractable epilepsy with MCD.

Keyword

Malformation of cortical development; Cortical dysplasia; Ketogenic diet; Epilepsy

MeSH Terms

Brain
Child
Diet
Epilepsy*
Humans
Ketogenic Diet*
Magnetic Resonance Imaging
Malformations of Cortical Development
Retrospective Studies
Seizures