To document the long-term outcome of the 83 children with difficult-to-control seizures who were enrolled prospectively in a study of the efficacy of the ketogenic diet and who had remained on the diet for 1 year.
A total of 150 consecutive children were entered prospectively into a study of the ketogenic diet's efficacy and tolerability. Three to 6 years after diet initiation, all 150 families were sent a survey inquiring about their child's current health status, seizure frequency, and current anticonvulsant medications. They were asked about their experience with the diet and reasons for discontinuation. Several telephone attempts were made to contact those who did not respond to the written questionnaire. Responses were entered in an Access database and analyzed.
In 1999, 3 to 6 years after initiating the diet, 107 of 150 families responded to a questionnaire. Thirty-five additional families were interviewed by telephone, 4 were lost to follow-up, and 4 children had died, unrelated to the diet. Of the original 150 patient cohort, 20 (13%) were seizure-free and an additional 21 (14%) had a 90% to 99% decrease in their seizures. Twenty-nine were free of medications, and 28 were on only 1 medication; 15 remained on the diet. There were no known cardiac complications.
Three to 6 years after initiation, the ketogenic diet had proven to be effective in the control of difficult-to-control seizures in children. The diet often allows decrease or discontinuation of medication. It is more effective than many of the newer anticonvulsants and is well-tolerated when it is effective.
Comments
Ketogenic Diet and Vitamin B9
It is since jears well known, that e.g. LAMICTAL (Lamotrogin) is a Antagonist of Vitamin B9 (Folsäure). So, Ketogenic Diet and reduction of B9 will do the same.
The ketogenic diet is NOT a "cultish" therapy. This aproach has been independantly reviewed and approved by the Blue Cross/Blue Shield Technology Assessment Center. It is now an accepted alternative approach for children with difficult to control seizures. We allso wish that we knew how the therapy works. Many are now beginning to work on its mechanisms of action. We are lookidng at the 3-6 year outcomes of children who did not stay on the diet. Perhaps they will provide a control group. Thank you for your insights.
Diet Survey
Interesting information on a "cultish" medical practice. Is this what one calls an anecdote of an anecdote? I can only shake my head in awe at how this type of therapy "works". I am also humbled by how we learned and scientific physicians constantly employ therapies that we have very little mechanistic understanding. I suppose that is the "art" of medicine. As for the article itself, of course, I wished that there was a control group of patients not on the diet so that I may see if they would have had similar results with there seizures over the same period. Finally, of course, I am wary of survey results from people who may report compliance whether there was actual compliance to a regimented diet or not. The world is full of similar testimonials from people who champion one diet or another for weight loss.