Programmpunkt

10:45–11:00

Titel: The influence of etiology on the efficacy of the ketogenic diet in a cohort of children with epileptic encephalopathy
ID: FV 28
Art: Abstractvortrag
Session: Freie Vorträge V

Referent: Chiara Häfele (Wien/AT)


Abstract - Text

To investigate whether the ketogenic diet is effective in different epileptic encephalopathies during childhood  according to etiology according to the new ILAE criteria of classification and terminology in 2017.

 

Methods: This study was planned as an explorative descriptive data analysis of a prospective longitudinal database from March 1999 to September 2018, which includes consecutive children treated with the KD at the Medical University Vienna.

The new classification of epilepsy was applied divided into the new range of etiologic groups: known (structural, genetic , metabolic, infectious, and immune etiologies)  as well as unknown causes. Response was defined as a seizure reduction > 50% after an evaluation period of at least 3 months. The proportion of seizure freedom (100% seizure

reduction) was analysed, as well as the responder rate.

 

Results:

201 children and adolescents were included into the cohort. Drop-outs due to compliance occurred in 14 patients (7%) during the first weeks of evaluation.

In one child the KD was established due to a complex I deficiency without seizures and was excluded from analysis .

 

 From the remaining 186 patients, 98 males and 88 females were included.

59 (32%) achieved long term-seizure freedom at last follow-up.

Seizure reduction >50% (i.e.responder rate) occurred in 122 (66%).

 

Etiology was known in 127 (68%) participants and 33 children achieved seizure freedom (26%), whereas in unknown etiologies 26 participants achieved seizure freedom (43%).

 

A seizure reduction > 50% (i.e. responder rate) was observed in 83 participants (65%) with known and in 39 participants with unknown (66%) etiology.

 

In the structural group 24 (31%) participants became seizure free, in the genetic subgroup 8 (21%) participants became seizure free, in the metabolic subgroup 1 participant (20%) became seizure free and in the infectious no participant (0%) became seizure free. No patients with immune mediated epilepsy were included into the cohort.

 

In the structural subgroup 54 (69%) participants were responders, in the genetic subgroup 26 (67%) participants were responders, in the metabolic subgroup 3 participants (60%) were responders and in the infectious subgroup no responders were observed.

 

Significance:

When looking at seizure freedom, unknown etiologies showed a higher rate of seizure freedom, as well as structural etiologies. However, a seizure reduction > 50% (responder rate) was equally distributed between unknown and known etiologies and within etiologic subgroups.