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Eur J Paediatr Neurol. 2016 Nov;20(6):798-809. doi: 10.1016/j.ejpn.2016.07.009. Epub 2016 Jul 17.

Ketogenic diet guidelines for infants with refractory epilepsy.

Author information

1
Erasmus Medical Center Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands. Electronic address: e.vanderlouw@erasmusmc.nl.
2
Wilhelmina Children's Hospital, University Medical Center Utrecht, The Netherlands. Electronic address: t.vandenhurk@umcutrecht.nl.
3
Matthews Friends Clinics, Lingfield, UK. Electronic address: e.neal@mfclinics.com.
4
University of Essen, Children's Hospital, Germany. Electronic address: baerbel.Leiendecker@uk-essen.de.
5
Great Ormond Street Hospital for Children, London, UK. Electronic address: Georgiana.Fitzsimmons@gosh.nhs.uk.
6
Medical University of South Carolina, USA. Electronic address: kenla@musc.edu.
7
Children's Mercy Hospital and Clinics, Overland Park, KS, USA. Electronic address: lmthompson@cmh.edu.
8
University of Modena and Reggio Emilia, Italy. Electronic address: maddalena.marchio@unimore.it.
9
Center of Pediatrics and Oncology, Chorzow, Poland. Electronic address: mdudzinskapl@yahoo.com.
10
Medical University Vienna, Austria. Electronic address: anastasia.dressler@meduniwien.ac.at.
11
Klinikum Aschaffenburg-Alzenau, Germany. Electronic address: Jorg.Klepper@klinikum-ab-alz.de.
12
Pediatric Epilepsy & Child Neurology Paris-Diderot University, France. Electronic address: stephane.auvin@aphp.fr.
13
UCL Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK. Electronic address: h.cross@ucl.ac.uk.

Abstract

BACKGROUND:

The ketogenic diet (KD) is an established, effective non-pharmacologic treatment for drug resistant childhood epilepsy. For a long time, the KD was not recommended for use in infancy (under the age of 2 years) because this is such a crucial period in development and the perceived high risk of nutritional inadequacies. Indeed, infants are a vulnerable population with specific nutritional requirements. But current research shows that the KD is highly effective and well tolerated in infants with epilepsy. Seizure freedom is often achieved and maintained in this specific patient group. There is a need for standardised protocols and management recommendations for clinical use.

METHOD:

In April 2015, a project group of 5 experts was established in order to create a consensus statement regarding the clinical management of the KD in infants. The manuscript was reviewed and amended by a larger group of 10 international experts in the KD field. Consensus was reached with regard to guidance on how the diet should be administered and in whom.

RESULTS:

The resulting recommendations include patient selection, pre-KD counseling and evaluation, specific nutritional requirements, preferred initiation, monitoring of adverse effects at initiation and follow-up, evaluation and KD discontinuation.

CONCLUSION:

This paper highlights recommendations based on best evidence, combined with expert opinions and gives directions for future research.

KEYWORDS:

Guidelines; Infant; Ketogenic diet; Refractory epilepsy

PMID:
27470655
DOI:
10.1016/j.ejpn.2016.07.009
[Indexed for MEDLINE]

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