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Efficacy of the ketogenic diet on ACTH‐ or corticosteroid‐resistant infantile spasm: a multicentre prospective control study
Author(s) -
Zhang Jie,
Chen Guohong,
Wang Juan,
Jiang Yuwu,
Yang Zhixian,
Xu Kaili,
Peng Jing,
Zhou Shuizhen,
Jiang Li,
Li Baomin,
Zhang Dongqing,
Liu Zhisheng,
Huang Lijuan,
Chen Chunhong,
Fang Fang,
Chen Yanhui,
Wu Yi,
Zhong Jianmin,
Zha Jian,
Yin Fei,
Yu Lifei,
Wu Ye
Publication year - 2021
Publication title -
epileptic disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.673
H-Index - 53
eISSN - 1950-6945
pISSN - 1294-9361
DOI - 10.1684/epd.2021.1256
Subject(s) - hypsarrhythmia , ketogenic diet , medicine , adrenocorticotropic hormone , prospective cohort study , ketosis , corticosteroid , etiology , pediatrics , anesthesia , epilepsy , hormone , endocrinology , psychiatry , diabetes mellitus
Objective . To determine the efficacy of ketogenic diet (KD) therapy on adrenocorticotropic hormone‐ (ACTH) or corticosteroid‐resistant infantile spasm (IS), and identify relevant associated factors. Methods . A prospective controlled study was undertaken at 10 tertiary children's medical centres in mainland China. Participants were non‐randomly assigned to KD therapy or control (adjustment of antiepileptic drugs). The primary outcome was the reduction in spasms and remission of hypsarrhythmia at the 16 th week, divided into Grade I (spasm‐free for at least one week with hypsarrhythmia remission), Grade II (≥50% spasm reduction and/or hypsarrhythmia remission) and Grade III (<50% spasm reduction with hypsarrhythmia). Results . In total, 227 patients were recruited and assigned to the KD (135 patients) and control (92 patients) groups. The efficacy in the KD group was superior to that in the control group (Grade I: 13.4% vs. 10.9%; Grade II: 40.7% vs. 20.7%, p =0.025). Patients with a ketogenic ratio <3:1 had a higher rate of Grade I than those with ketogenic ratio ≥3:1 (66.7% vs. 33.3%, p =0.037). No significant correlation was found between the efficacy of KD and level of serum ketosis, aetiology of IS, or age. Significance . The efficacy of KD therapy was superior to adjustment of oral antiepileptic drugs in children with ACTH‐ or corticosteroid‐resistant infantile spasms.