Ketogenic diet for infantile spasms refractory to first-line treatments: An open prospective study

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• 作者：Maria Elisa Pires^a ; Adina Ilea^a ; Emilie Bourel^b ; Vanina Bellavoine^a ; Dana Merdariu^a ; Patrick Berquin^b ; Sté ; phane Auvin^a ; ^c ; ^d ; ^{auvin@invivo.edu} ; ^{stephane.auvin.rdb@gmail.com}
• 关键词：Felbamate ; Infantile spasms ; Ketogenic diet ; Topiramate
• 刊名：Epilepsy Research
• 出版年：2013
• 出版时间：July, 2013
• 年：2013
• 卷：105
• 期：1-2
• 页码：189-194
• 全文大小：402 K

文摘

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Summary

Ketogenic diet (KD) is an efficient treatment for refractory epilepsy including infantile spasms (IS). We evaluated the effect of a KD to treat IS as a third-line treatment, after vigabatrin (VGB) and steroids. We evaluated the efficacy and the tolerability of KD in IS using the rate of seizure-free patients at 1 month.

Methods

We conducted an open study using the data from a prospective database of two French child neurology departments (Amiens & Robert Debr¨¦-Paris, France) over a three-year period. All the patients followed the KD for 6 months. The addition of an antiepileptic drug was allowed after 1 month of KD in the non-seizure-free patients.

Results

17 patients were treated by KD for IS. The KD was initiated at the mean age of 9.4 ¡À 1.1 months. After 1 month with KD, 6/17 (35 % ) patients were seizure free while 11/17 (65 % ) were seizure-free after the third month. However, an additional antiepileptic drug (felbamate or topiramate) was given to all patients that were not seizure-free under KD. The KD was well tolerated.

Conclusion

Our responder rate is similar to previous studies despite an early use (before 1-year-old) and the use of KD after VGB and steroids. The KD was well-tolerated in this population of young infants. Felbamate leads to an increase in the responder rate after the use of KD.