Children with Epilepsy With Different Baseline Blood Beta‐hydroxybutyrate Have Similar Blood Beta‐hydroxybutyrate and Response on Ketogenic Therapy

Background Children with epilepsy may have fasting blood beta‐hydroxybutyrate (BOB) similar to (low BOB) or higher than (high BOB) healthy children, which could reflect differences in metabolism or usual diet. BOB increases in children with epilepsy on Ketogenic Therapy (KT), where fat is most of the Calories, but it is unclear if children with low or high BOB at baseline respond differently to KT. Objective To test the hypothesis that both groups of children with epilepsy (low or high BOB) can respond to KT with a reduction in seizures and need for antiepileptic drugs (meds). Methods Patients were divided into low or high BOB group at baseline. BOB, seizure response, and med response were collected 1.5 to 3.5 years on KT. Seizure response and med response (including aspects of seizures or meds in addition to number) were determined the month BOB was collected. Seizure response and med response are a percent change from baseline where 0% reflects 0 seizures or meds. Results Low BOB group was significantly different (p<0.001) from high BOB group at baseline. BOB, seizure response, and med response were not significantly different between the two groups at 1.5‐3.5 years on KT.BOB at baseline Baseline 1.5‐3.5 years on KTBOB (mg/dL) BOB (mg/dL) Seizure Response (%) Med Response (%) Low (n=10) 4.2 (2.4)* 32.6 (17.6) 50.0 (86.5) 27.2 (32.2) High (n=10) 20.7 (11.1) 41.5 (14.9) 27.2 (41.8) 60.2 (45.9)Data are mean (± SD), * is (p<0.001) compared to high Conclusion Children with epilepsy with different baseline blood BOB have similar BOB, seizure response, and med response on KT for 1.5‐3.5 years on KT. Supported in part by the NIH/NCATS CTSA to the University of Florida UL1 TR000064