TDNet Discover

Background: Drug-resistant epilepsy (DRE) is a disorder in which an epileptic patient’s seizures cannot be reduced or prevented with adequate trials of two anti-seizure medications. Up to 20% of pediatric epilepsy patients suffer from DRE. According to the current standard of care, the next step in treatment after failure of pharmaceutical therapy is invasive brain surgery. Lifestyle modifications are not routinely offered when following the current standard of care. Purpose: This research sought to explore the possibility of the ketogenic diet (KD) as a safe, non-invasive treatment option for pediatric epilepsy patients suffering from DRE. Methods: An evidence-based clinical review was conducted to obtain studies that were high levels of evidence regarding the implementation of a ketogenic diet in pediatric drug-resistant epilepsy patients. The researchers conducted a search of 3 databases with specific terms, phrases, and limits. Each search result had a title and abstract review using specified inclusion and exclusion criteria. Search and review results were recorded in a search log. Quality assessment tools from National Heart, Lung, and Blood Institute were used to evaluate research studies. Only studies rated as “good” were included in this review. Data extraction for analysis was performed on the 3 articles selected. Results: Two systematic reviews and a meta-analysis were analyzed. The studies investigated rates of seizure frequency reduction and seizure freedom when pediatric DRE patients followed a KD. Patients were 3 times more likely to achieve seizure freedom when following a KD. Patients also had over 50% reduction in seizures with a KD. Conclusion: While the current standard of care offers the KD as a last-line alternative, research indicates that it significantly improves seizure frequency and freedom for patients who would IV like conservative treatments before surgery. The standard of care should be updated to allow a KD to be offered to patients prior to invasive surgery.