Epilepsy: Can a ketogenic diet improve symptoms in patients with super-refractory status epilepticus?

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Authors are reporting promising findings from a phase I/II trial.

Findings from a new trial suggest following a ketogenic diet is a “feasible” option for people with super-refractory status epilepticus (SRSE).

For the trial, researchers recruited 15 patients, aged 18 to 80 years, hospitalised with SRSE. The patients had taken an average of eight anti-seizure medications before a commercially prepared ketogenic diet was given via gastrostomy tube.

One patient was taken off the diet when family members requested to withdraw care and the patient subsequently died. In 11 of the remaining 14, who completed the full course of the ketogenic diet, super-refractory seizures stopped, with eight recovering within a week after the episode started. Five patients in the study died, including the patient for which care was withdrawn and three patients who were not helped by the diet.

The researchers now plan to carry out phase III randomised controlled clinical trials to determine the actual rate of effectiveness by comparing those treated with the ketogenic diet to a group tube-fed a normal, nonketogenic diet.

Dr. Mackenzie C. Cervenka, author and associate professor of neurology and director of the Adult Epilepsy Diet Center at Johns Hopkins University School of Medicine concluded: “The ketogenic diet is promising for at least a subset of patients.”

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