The outcome of children with intractable seizures

A 3- to 6-year follow-up of 67 children who remained on the ketogenic diet less than one year

Elisabeth Breese Marsh, John M. Freeman, Eric H Kossoff, Eileen P.G. Vining, James Rubenstein, Paula L. Pyzik, Cheryl Hemingway

Research output: Contribution to journalArticle

Abstract

Purpose: To determine the long-term outcome of children with difficult-to-control seizures who remained on the ketogenic diet for 50% controlled at follow-up than were those managed with medications alone (p <0.05). A statistically significant difference in long-term outcome was noted between those who responded while on the diet, even if they discontinued it before 1 year, and those who did not (p <0.05), but no statistical correlation was found between length of time that they had remained on the diet and long-term prognosis. Conclusions: Almost half of the children who discontinued the diet during the first year had a decrease in seizures when assessed 3-6 years later. Twenty-two percent of these had become seizure free without surgery. We were unable to ascertain whether this may have been due to new medications. Those who saw some improvement while on the diet were more likely to have a favorable long-term outcome. Resective surgery, in children who were candidates, or vagal nerve stimulation (VNS) implantation, was more likely to result in significant seizure improvement than was management with medications alone. Whether or not the diet was effective, most families did not regret trying it and would recommend it to others.

Original languageEnglish (US)
Pages (from-to)425-430
Number of pages6
JournalEpilepsia
Volume47
Issue number2
DOIs
StatePublished - Feb 2006

Fingerprint

Ketogenic Diet
Seizures
Diet
Vagus Nerve Stimulation
Emotions

Keywords

  • Children
  • Intractable epilepsy
  • Ketogenic diet

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

@article{ddf79f6c7edf4637941e8b7f9a6d9354,
title = "The outcome of children with intractable seizures: A 3- to 6-year follow-up of 67 children who remained on the ketogenic diet less than one year",
abstract = "Purpose: To determine the long-term outcome of children with difficult-to-control seizures who remained on the ketogenic diet for 50{\%} controlled at follow-up than were those managed with medications alone (p <0.05). A statistically significant difference in long-term outcome was noted between those who responded while on the diet, even if they discontinued it before 1 year, and those who did not (p <0.05), but no statistical correlation was found between length of time that they had remained on the diet and long-term prognosis. Conclusions: Almost half of the children who discontinued the diet during the first year had a decrease in seizures when assessed 3-6 years later. Twenty-two percent of these had become seizure free without surgery. We were unable to ascertain whether this may have been due to new medications. Those who saw some improvement while on the diet were more likely to have a favorable long-term outcome. Resective surgery, in children who were candidates, or vagal nerve stimulation (VNS) implantation, was more likely to result in significant seizure improvement than was management with medications alone. Whether or not the diet was effective, most families did not regret trying it and would recommend it to others.",
keywords = "Children, Intractable epilepsy, Ketogenic diet",
author = "Marsh, {Elisabeth Breese} and Freeman, {John M.} and Kossoff, {Eric H} and Vining, {Eileen P.G.} and James Rubenstein and Pyzik, {Paula L.} and Cheryl Hemingway",
year = "2006",
month = "2",
doi = "10.1111/j.1528-1167.2006.00439.x",
language = "English (US)",
volume = "47",
pages = "425--430",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - The outcome of children with intractable seizures

T2 - A 3- to 6-year follow-up of 67 children who remained on the ketogenic diet less than one year

AU - Marsh, Elisabeth Breese

AU - Freeman, John M.

AU - Kossoff, Eric H

AU - Vining, Eileen P.G.

AU - Rubenstein, James

AU - Pyzik, Paula L.

AU - Hemingway, Cheryl

PY - 2006/2

Y1 - 2006/2

N2 - Purpose: To determine the long-term outcome of children with difficult-to-control seizures who remained on the ketogenic diet for 50% controlled at follow-up than were those managed with medications alone (p <0.05). A statistically significant difference in long-term outcome was noted between those who responded while on the diet, even if they discontinued it before 1 year, and those who did not (p <0.05), but no statistical correlation was found between length of time that they had remained on the diet and long-term prognosis. Conclusions: Almost half of the children who discontinued the diet during the first year had a decrease in seizures when assessed 3-6 years later. Twenty-two percent of these had become seizure free without surgery. We were unable to ascertain whether this may have been due to new medications. Those who saw some improvement while on the diet were more likely to have a favorable long-term outcome. Resective surgery, in children who were candidates, or vagal nerve stimulation (VNS) implantation, was more likely to result in significant seizure improvement than was management with medications alone. Whether or not the diet was effective, most families did not regret trying it and would recommend it to others.

AB - Purpose: To determine the long-term outcome of children with difficult-to-control seizures who remained on the ketogenic diet for 50% controlled at follow-up than were those managed with medications alone (p <0.05). A statistically significant difference in long-term outcome was noted between those who responded while on the diet, even if they discontinued it before 1 year, and those who did not (p <0.05), but no statistical correlation was found between length of time that they had remained on the diet and long-term prognosis. Conclusions: Almost half of the children who discontinued the diet during the first year had a decrease in seizures when assessed 3-6 years later. Twenty-two percent of these had become seizure free without surgery. We were unable to ascertain whether this may have been due to new medications. Those who saw some improvement while on the diet were more likely to have a favorable long-term outcome. Resective surgery, in children who were candidates, or vagal nerve stimulation (VNS) implantation, was more likely to result in significant seizure improvement than was management with medications alone. Whether or not the diet was effective, most families did not regret trying it and would recommend it to others.

KW - Children

KW - Intractable epilepsy

KW - Ketogenic diet

UR - http://www.scopus.com/inward/record.url?scp=33645297386&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33645297386&partnerID=8YFLogxK

U2 - 10.1111/j.1528-1167.2006.00439.x

DO - 10.1111/j.1528-1167.2006.00439.x

M3 - Article

VL - 47

SP - 425

EP - 430

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 2

ER -