Abstract
More than 25 % of children with epilepsy develop refractory seizures unresponsive to both old and new generation anticonvulsants. Since such seizures have a serious negative impact on the quality of life, other treatment options are considered. The ketogenic diet is a well-known treatment for managing refractory seizures, although its mechanism of action is unknown. Studies have shown that this diet is as good as, or better than, any of the newer medications in reducing seizure frequency. However, concerns about adverse effects have been raised. We conducted an open label trial to show the effects of this diet on serum lipid profile. Thirty-three children with refractory epilepsy were treated with the ketogenic diet and were followed for 6 months. Their serum lipid profile was assessed at baseline, and at 3 and 6 months after initiating the diet. Seizure frequency was reduced in 63 % of children (no seizures in 2/33 and reduced >50 % in 19/33). However, after 6 months of administering the diet, median triglyceride was significantly increased (from 84 to 180 mg/dl, P < 0.001), median total cholesterol was significantly increased (from 180 to 285 mg/dl, P < 0.001), median serum low-density lipoprotein (LDL) was significantly increased (from 91 to 175 mg/dl, P < 0.001), and median serum high-density lipoprotein (HDL) was significantly increased (from 51 to 58 mg/dl, P < 0.001). Results of this study indicate that a classic ketogenic diet in children with refractory seizures is effective in seizure reduction, but leads to development of hypercholesterolemia and hypertriglyceridemia.
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Acknowledgments
This paper is from the thesis of Parviz Karimi, M.D., registration number 9211118002. The Research Deputy of Tehran University of Medical Sciences provided financial and logistic support for this study (Grant number: 134395-9211118002), but had no role in study design; data collection, analysis, or interpretation; writing the report; or in the decision to submit the article for publication. The authors are grateful to all parents and patients for their participation in this study. We are extremely indebted to the authorities of the Research Deputy of Tehran University of Medical Sciences for their financial and logistic support and the staff of nutrition ward of the Children’s Medical Center for their kind cooperation.
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The study design was approved by the Ethical Board Committee of the children’s medical center and Tehran University of Medical Sciences.
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Written informed consent, approved by the Institutional Review Board, was obtained from the parents of participants before enrolment.
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Zamani, G.R., Mohammadi, M., Ashrafi, M.R. et al. The effects of classic ketogenic diet on serum lipid profile in children with refractory seizures. Acta Neurol Belg 116, 529–534 (2016). https://doi.org/10.1007/s13760-016-0601-x
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DOI: https://doi.org/10.1007/s13760-016-0601-x