Treatment With Ketogenic Diet In 31 Children With Infantile Spasms

Objective: To investigate the short-term efficacy and prognostic factors of ketogenic diet(KD)on children with infantile spasms(IS).Methods: This study retrospectively reviewed 31 children with IS treated with KD in children's Hospital of Nanjing Medical University between January 2013 to May 2016.The seizure frequency and adverse reaction were assessed prior to the KD and then one week,three months and again six months after the initiation of the therapy.The efficacy grade is divided into seizure-free,significant effect(seizure reduction >75%),effective(seizure reduction >50%),ineffective(seizure reduction <50%).The total effective rate was(seizure-free + significant effect + effective)number of cases ÷number of retention × 100%.The seizures frequency of children was observed and recorded by their parents.IBM SPSS data processing software(SPSS Statistics version 20)was used for data processing,continuous parameter data were analyzed by t test,and the nonparametric data were analyzed by chi square test.Results: Thirty-one children(22 boys,9 girls)aged 7 months to 6years,and the course of disease ranged from 2 months to 5 years.The reduction of seizure frequency has been observed one week after KD treatment(P<0.05).After 3 months and 6months,the retention rates were 74.2% and 58.1%,and the effective rates were 39.1%and 61.1%,respectively.The effective rate was increased with time,and the retention rate decreased.Statistical results showed that the etiology,age of onset,onset time before KD treatment,and the age of KD therapy,history of corticosteroid treatment were not the factors influencing the prognosis of KD.During the process of KD,thirty one children were found 7 cases crying antifeedant(22.6%),3 cases fever at the first week of beginning(9.7%),16 cases had vomiting and / or diarrhea(51.6%),4 cases had constipation(12.9%),no serious side effects has been found,such as kidney stones and fatty liver,that need to stop KD.Conclusion: KD is a relatively safe and effective method for treatment of infantilespasms in children,but the retention rates need to be improved.