Clinical Observation Of Ketogenic Diet Adding Treatment For Children With Spastic Epilepsy

Objective:To study the clinical efficacy,the dynamic changes of EEG,the effect on the neurobehavioral development,the adverse reactions and compliances of patients of ketogenic diet(KD)adding treatment for children with spastic epilepsy.Methods:19 pediatric patients with spastic epilepsy who had received KD therapy were recruited by our hospitial and cooperative hospital from May 2015 to August 2016.Engel grade was used to evaluate the clinical efficacy at 1,3 and 6months after treatment.We recorded the dynamic changes of EEG,the adverse reactions of ketogenic diet(KD)and the reasons why the children gave up.The changes of neurobehavioral development of the children were mainly observed by their parents.Results:Totally 19 patients(3 months old to 5 years and 5 months old)of spastic epilepsy with 7 boys and 12 girls were enrolled in the study.After treatment for 1,3and 6 months,the total effective rate was respectively 78.9%,77.8%and 86.7%,.The rate of no seizure(grade 1)was respectively 15.8%,22.2%,and 26.7%,and the total number of no seizure is3,4,4,after treatment for 1,3and 6 months.The clinical efficacy of KD has no statistical significance with treatment time,age and sex(P>0.05).After treatment for 1,3and 6 months,the improvement rate of electroencephalogram(EEG)was 31.6%,72.2%,86.7%,respectively.The changes of EEG has no statistical significance with treatment time(P>0.05).After treatment for 3 months,the clinical efficacy of KD has statistical significance with the changes of EEG(P<0.05).After 6 months of KD treatment,there were a total of 15 cases of developmental progress,including 11 cases had significant improvement in motor ability,5 cases had improvement in cognitive function,and 4 cases had improvement in language ability.The main adverse reactions of KD treatment are gastrointestinal symptoms,and the symptoms were mild,no serious adverse reactions.There were 15 patients who had been treated for more than 6 months,14 cases continued treatment,the remaining 5 cases gave up because of short-term treatment ineffective,food intolerance,gastrointestinal symptoms,and so on.Conclusions:Ketogenic diet(KD)adding treatment for children with spastic epilepsy is safe and effective.More than 85%reduction in seizures.There were a total of 15 cases of developmental progress.No serious adverse reactions have been observed.We also need to strengthen the management of the ketogenic diet,improve the formula of ketogenic diet,enhance health education,and improve the compliance of their families.We need a longer clinical observation of larger samples,then we can provide more suitable and more effective treatments for children with spastic epilepsy.