Ketogenic diet for infants with epilepsy: A literature review

Raffaele Falsaperla; Gabriella D'Angelo; Andrea D Praticò; Laura Mauceri; Massimo Barbagallo; Piero Pavone; Stefano Catanzaro; Eloisa Gitto; Giovanni Corsello; Martino Ruggieri

doi:10.1016/j.yebeh.2020.107361

Ketogenic diet for infants with epilepsy: A literature review

Epilepsy Behav. 2020 Nov:112:107361. doi: 10.1016/j.yebeh.2020.107361. Epub 2020 Sep 28.

Affiliations

¹ General Pediatrics and Pediatric Acute and Emergency Unit, Policlinico-Vittorio-Emanuele University Hospital, University of Catania, Catania, Italy.
² Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology of Adult and Childhood "G. Barresi", University Hospital "G. Martino", Messina, Italy.
³ Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Italy. Electronic address: andrea.pratico@unict.it.
⁴ Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Italy.
⁵ Department of Maternal and Child Health, University of Palermo, Palermo, Italy.

PMID: 33181904
DOI: 10.1016/j.yebeh.2020.107361

Abstract

The ketogenic diet (KD) is an established, nonpharmacological treatment for drug-resistant epilepsy (DRE). Actually, KD and its variants have been shown to be elective and resolute for patients with glucose transporter type 1 (GLUT1) deficiency. The aim of this review was to study the use of KD and its variants in infancy, including the neonatal age, and demonstrate the safety and efficacy of this treatment in patients with the age of 0-23 months affected by DRE already subjected to pharmacological approach attempts. A literature search was conducted using PubMed as the medical database source. We used the age limit of 0-23 months, and we considered only articles published between the years 2015 and 2018, in light of increasing interest worldwide in the use of KD and its variants to manage DRE. We included 52 publications: 1 Cochrane study, 22 retrospective studies, 9 prospective studies, 4 randomized controlled trials (RCTs), 12 clinical cases, and 4 clinical reviews. Literature data showed that KD and its variants are safe and useful in patients with the age of 0-23 months with DRE. Classical KD is of first choice in the treatment of GLUT1 deficiency. Earlier introduction of KD in GLUT1 promises a better outcome and a decrease in seizure frequency in these patients.

Keywords: Drug-resistant epilepsy; Epilepsy; Glucose transporter type 1 deficiency; Infant; Ketogenic diet.

Publication types

Review

MeSH terms

Diet, Ketogenic / adverse effects
Diet, Ketogenic / methods*
Disease Management
Drug Resistant Epilepsy / diet therapy*
Epilepsy / diet therapy*
Female
Glucose Transporter Type 1
Humans
Infant
Infant, Newborn
Male
Seizures / etiology
Treatment Outcome

Substances

Glucose Transporter Type 1