Incidence of potential adverse events during hospital‐based ketogenic diet initiation among children with drug‐resistant epilepsy

Epilepsia Open - Tập 5 Số 4 - Trang 596-604 - 2020
Ali Mir1, MahmoodDhahir Al-Mendalawi1, Abdullah Alamri2, Mohammed Al-Qahtani1, Entisar Hany3, Aqeel Hussain4, Michael Joseph1, Shahid Bashir1
1Department of Pediatric Neurology, Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
2College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
3Department of Nutrition, King Fahad Specialist Hospital, Dammam, Saudi Arabia
4Department of Pediatrics, King Fahad Specialist Hospital, Dammam, Saudi Arabia

Tóm tắt

AbstractObjectiveDue to the possibility of serious adverse events (AE), patients are commonly admitted to hospital for 3‐5 days for ketogenic diet (KD) initiation. This study examined the incidence of potential AE during admission for KD initiation to investigate the possibility of safely initiating a KD at home.MethodsChildren with drug‐resistant epilepsy (DRE) who were admitted to hospital for 5 days for KD initiation were retrospectively studied.ResultsA total of 66 children (59% female) were analyzed. The mean age at the initiation of the KD was 48.0 ± 38.4 months, and the mean weight was 14.6 ± 6.3 kg. The median number of anticonvulsant medications used at the time of KD initiation was 3. The etiology of the DRE was structural in 4.5%, hypoxic ischemic encephalopathy in 10.6%, genetic/metabolic in 31.8%, acquired in 10.6%, and unknown in 42.2%. The potential AE occurred in 28.7% of patients, including hypoglycemia (20%), hypoactivity (6.1%), somnolence (3%), and vomiting (7.6%). A univariate analysis of the clinical characteristics of the AE and no AE groups showed a statistically significant difference in weight (P = 0.003) and age (P = 0.033). The concurrent use of topiramate was found to have a near‐significant association (P = 0.097) between the groups. The groups' urine ketone levels on all 5 days were compared, and a statistically significant difference was found on day 3 (P = 0.026). A statistically significant difference in the serum bicarbonate levels (P = 0.038) was found between the patients taking topiramate and those not taking it.SignificanceThe incidence of AE during admission for KD initiation was found to be low. The AE either required no intervention or were easily managed with simple interventions. Thus, in carefully selected patients, it may be possible to initiate a KD at home if the parents are adequately prepared and monitored.

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Epilepsia Open

Tập 5 Số 4

596-604

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