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Efficacy of the Ketogenic Diet for the Treatment of Refractory Childhood Epilepsy: Cerebrospinal Fluid Neurotransmitters and Amino Acid Levels

Authors :
Esperanza Castejón
Aida Ormazabal
Marta Molero-Luis
Angels García-Cazorla
Francesc Sanmartí
Andrea Sariego-Jamardo
Rafael Artuch
Dolores García-Arenas
Source :
Pediatric Neurology. 53:422-426
Publication Year :
2015
Publisher :
Elsevier BV, 2015.

Abstract

Objective The mechanisms of the ketogenic diet remain unclear, but several predictors of response have been proposed. We aimed is to study the relationship between the etiology of epilepsy, cerebrospinal fluid neurotransmitters, pterins, and amino acids, and response to a ketogenic diet. Methods We studied 60 patients who began classic ketogenic diet treatment for refractory epilepsy. In 24 of 60 individuals, we analyzed cerebrospinal fluid neurotransmitters, pterins, and amino acids in baseline conditions. Mean age at epilepsy onset was 24 months, 83.3% were focal epilepsies, and in 51.7% the etiology of the epilepsy was unknown. Results Six months after initiating the ketogenic diet, it was effective (greater than a 50% reduction in seizure frequency) in 31.6% of patients. We did not find a link between rate of efficacy for the ketogenic diet and etiologies of epilepsy, nor did we find a link between the rate of efficacy for the ketogenic diet and cerebrospinal fluid pterins and biogenic amines concentrations. However, we found statistically significant differences for lysine and arginine values in the cerebrospinal fluid between ketogenic diet responders and nonresponders, but not for the other amino acids analyzed. Significance The values of some amino acids were significantly different in relationship with the ketogenic diet efficacy; however, the epilepsy etiology and the cerebrospinal fluid biogenic amine and pterin values were not.

Details

ISSN :
08878994
Volume :
53
Database :
OpenAIRE
Journal :
Pediatric Neurology
Accession number :
edsair.doi.dedup.....8415f741391a88ebe731390730f97b5e
Full Text :
https://doi.org/10.1016/j.pediatrneurol.2015.07.013