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Comparison of short- versus long-term ketogenic diet for intractable infantile spasms

Authors
 Hoon-Chul Kang  ;  Yun Jin Lee  ;  Joon Soo Lee  ;  Eun Joo Lee  ;  Soyong Eom  ;  Su Jeong You  ;  Heung Dong Kim 
Citation
 Epilepsia, Vol.52(4) : 781-787, 2011 
Journal Title
 Epilepsia 
ISSN
 0013-9580 
Issue Date
2011
Abstract
PURPOSE: To compare the prognoses between short-term (8 months) and conventional long-term (> 2 years) trials involving patients with refractory infantile spasms who successfully completed the ketogenic diet (KD). METHODS: Of 40 patients who achieved seizure-free outcomes and showed improvement in hypsarrhythmic patterns within 6 months of the KD, with a 3:1 fat to nonfat ratio as an add-on treatment, 16 patients were randomized into the short-term trial group and the diet was tapered throughout two additional months. Twenty-four patients were randomized into a long-term trial group, and 19 patients could successfully discontinue the diet after 2 years. Primary outcome measures included seizure relapse and frequency of 35 patients for > 12 months after successful completion of the KD. KEY FINDINGS: Of 16 patients in the short-term trial group, two patients relapsed with clusters of spasms, and one patient had recurrence of occasional focal seizures. Of 19 patients in the long-term trial group, two patients progressed to Lennox-Gastaut syndrome and one patient experienced recurrence of occasional focal seizures with secondary generalization. An early response to the KD, evidenced by short latency before seizure freedom and disappearance of hypsarrythmia and cryptogenic etiology, may indicate a successful early discontinuation of the KD. Significant growth failure was complicated only in conventional long-term trial group. SIGNIFICANCE: Use of the KD for only 8 months in children who become spasm-free appears to be justified, with similar outcomes, recurrence rate, and less growth disturbance than a longer-term, traditional use.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92820
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2010.02940.x/abstract
DOI
10.1111/j.1528-1167.2010.02940.x
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실)
Yonsei Authors
강훈철(Kang, Hoon Chul) ORCID logo https://orcid.org/0000-0002-3659-8847
김흥동(Kim, Heung Dong)
엄소용(Eom, So Yong)
이준수(Lee, Joon Soo)
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