Ketogenic Diet Significantly Reduces Seizures in Children with Infantile Spasms

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The high-fat, low-carbohydrate diet may provide a new treatment option for the condition, which is often not effectively treated with medication.

Ketogenic diets can dramatically reduce or even completely eliminate seizures in children with infantile spasms, researchers at Johns Hopkins Children’s Center, led by Eric Kossoff, MD, have found.

In 2002, a small study by the same group of researchers at Hopkins Children’s revealed that the diet was effective in treating infantile spasms in a small group of children. Among the 104 children treated in the new study, almost 40% were seizure-free for at least six months. These results were seen in children who had been on the ketogenic diet for anywhere from a few days to as long as 20 months. After three months on the ketogenic diet, one-third of children had 90% fewer seizures; after nine months, nearly one-half of the children experienced 90% fewer seizures. Neurological and cognitive development also improved for study participants. Nearly two-thirds of children experienced improvement in these areas after starting the diet, and almost 30% of patients were weaned off anti-seizure medications.

According to Kossoff, infantile spasms, or West syndrome, are not often effectively treated with anti-seizure medications. These seizures can lead to brain damage when they are not effectively controlled, a problem that makes the need for a cure or effective treatment even more urgent.

“Stopping or reducing the number of seizures can go a long way toward preserving neurological function, and the ketogenic diet should be our immediate next line of defense in children with persistent infantile spasms who don’t improve with medication,” Kossoff said.

The researchers also examined the efficacy of the ketogenic diet as a first-line therapy for 18 newly diagnosed infants who had not been treated with drugs. Although the diet appeared to be effective—10 of the infants were seizure-free within two weeks of starting the regimen—the researchers caution that further, larger studies must be conducted to determine which patients will benefit most from the diet before medications.

Writing in Epilepsia, the researchers conclude that the ketogenic diet “is an efficacious therapy for IS in approximately two-thirds of patients treated, and it should be considered strongly after failure of corticosteroids and vigabatrin.”

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