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This study was conducted to develop a measurement tool to achieve ketogenic diet management in parents of children with epilepsy and examine its Turkish psychometric properties. The study was conducted on 317 parents using a descriptive correlational method. Data analysis and evaluation were performed using factor analysis, Cronbach's alpha, and item – total score correlation. The scale consists of 20 items and unidimensional factor. As a result of the exploratory factor analysis, the total explained variance of the unidimensional factor was 63.809%. Cronbach's alpha coefficient of the scale was 0.971. The four-weeks test-retest reliability evaluated with intra-class correlation was 0.87. Confirmatory factor analysis indicated, the model fit index results were recorded as follows: 0.95 as the Goodness-of-Fit Index; comparative fit index, 0.96 and normed fit index, 0.94. The study determined that the Ketogenic Diet Management Scale for Children with Epilepsy-Parent Form is a measurement tool that can be used by health professionals and that is used to evaluate parents' ketogenic diet knowledge. [ABSTRACT FROM AUTHOR]

The Coronavirus disease-2019 pandemic has led to the spread of telemedicine management of ketogenic diet therapy (KDT) in children with drug-resistant epilepsy (DRE). In this study, we evaluated the views and satisfaction of families about telemedicine and KDT management. Families of 25 children who underwent KDT for DRE were included in the 17-item questionnaire. Nearly half of the families had a primary education level. Most children with DRE were in the process of maintaining KDT. 88% of the families were applying KDT with telemedicine due to the pandemic. 60% of families found it difficult to start KDT via telemedicine, but 96% reported that reaching the KDT team via telemedicine was sufficient. The necessity of laboratory analyzes and evaluation of the results of the KDT team was evaluated as good in 72%, and their response when dietary changes or vitamin addition was required was evaluated as good in 68%. All families were satisfied with the management of the KDT team in emergencies. 60% of the family recommended others to follow the KDT with telemedicine at all times and 40% recommended them during the pandemic period. According to the results of our study, in selecting patients who will be started with telemedicine and KDT, it should be noted that the families have sufficient education levels. The use of the telemedicine method may be a good option in the presence of an experienced and trained team in KDT management. [ABSTRACT FROM AUTHOR]

Background. We aimed to investigate the effectiveness of ketogenic diet (KD) in children with various types of refractory epilepsy. Methods. A total of 91 children (49 females) aged 3 to 193 months (median, 52 months) with drug resistant epilepsy who received KD treatment for at least 12 months were enrolled in the study. Seizure frequency, adherence to diet, reason for discontinuation of KD, and adverse effects were recorded. Response was defined as =50% improvement in seizure frequency compared to baseline. We also searched for influences of different variables on the outcome. Results. Intent-to-treat analysis revealed an improvement in seizure frequency for =50% in 73.6%, 80.2%, 75.8%, 73.6%, and 70.3% of patients at month-1, -3, -6, -9, and month-12, respectively. Overall, 32 (35.2%) patients remained seizure-free at month-12. There was no significant differences between responders and nonresponders in terms of age at onset of epilepsy, age at onset of KD, gender, or etiology. Mild hyperlipidemia was associated with a higher response rate. At the last follow-up (median: 20 months), 38 (41.8%) patients were still maintained on KD. While 15.4% of patients completed the diet with a success in seizure control, remainder discontinued KD due to lack of efficacy (23.1%), non-adharence to diet (11%), intercurrent infection (4.4%), adverse effects (3.3%), and death (1.1%). Conclusion. Ketogenic diet treatment appears to be effective in about two-thirds of children with various types of drug-resistant epilepsy, including one-third remaining seizure free. Mild hyperlipidemia seems to be associated with a higher response rate. Discontinuation of KD is mostly due to lack of efficacy or nonadherence, and rarely side effects. [ABSTRACT FROM AUTHOR]

Background: Ketogenic diet (KD) is a valuable treatment option for patients with medication-resistant epilepsy. It is associated with a number of side effects. However limited data are available for the long-term effects of KD on serum lipid levels.Purpose: The aim of this study was to investigate the long-term effects of KD on serum lipid concentrations in children with medication-resistant epilepsy in daily clinical practice.Method: A total of 73 children (40 girls) aged 3 to 193 months (median, 53 months) with medication-resistant epilepsy who received a KD treatment for at least 12 months between 2014 and 2019 years were enrolled in the study. All children were started on a KD with 3:1 ratio which was then adjusted between 2:1 to 4:1 after the onset of KD as clinically necessary. Serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride concentrations and body mass index-standard deviation scores (BMI-SDS) were measured at onset and at 1, 6 and 12 months of treatment, and also in 40 of these patients they were measured at 18 and 24 months of treatment.Results: Dyslipidemia was observed in 71.2, 63, 63, 50, and 52.5% of the patients, at 1, 6, 12, 18, and 24 months, respectively. Median total cholesterol and triglyceride concentrations increased significantly at month-1, and although these high levels persisted for 24 months, the increase did not continue and showed a downward trend. However, this increase did not occur in the subset of patients with pre-existing dyslipidemia. Compared to baseline values, total cholesterol and triglyceride concentrations were higher at all time points, except 24-month cholesterol values. During the 24-month treatment period, BMI-SDS increased and the number of antiepileptic drugs decreased significantly.Conclusion: Total cholesterol and triglyceride concentrations appear to increase during the first month of KD treatment, and although these high values persist for 24 months, the increase does not continue, on the contrary, it approaches the normal values by drawing a downward trend. However, cholesterol and triglyceride concentrations do not increase in the subset of patients with pre-existing dyslipidemia. [ABSTRACT FROM AUTHOR]