PT22 - MODIFIED KETOGENIC DIET THERAPY REDUCES SEIZURES AND PREVENTS LIVER STEATOSIS IN PATIENTS WITH REFRACTORY EPILEPSY

PT22

MODIFIED KETOGENIC DIET THERAPY REDUCES SEIZURES AND PREVENTS LIVER STEATOSIS IN PATIENTS WITH REFRACTORY EPILEPSY

C. G. Marques^1,*, J. G. de Souza¹, N. R. T. Damasceno^1,2

¹Faculty of Medicine, ²Faculty of Public Health, University of São Paulo, São Paulo, Brazil

Rationale: Ketogenic diet (KD) is a well-established adjuvant treatment for pharmacoresistant epilepsy. We developed a Modified Ketogenic Diet (MKD) and evaluated its efficacy on epileptic seizure reduction and metabolic parameters control in patients with refractory epilepsy.

Methods: Clinical trial involved children of both sexes. MKD with <20% in saturated fatty acids, >50% increase in unsaturated fatty acids, and a 50% reduction in the ω6/ω3 ratio compared to classic KD. Following parameters were analyzed at baseline, 3- and 6 months: seizure frequency, lipid profile, glucose, liver biomarkers (AST, ALT, GGT, ALP), using ELISA kits; and liver ultrasound. RM-ANOVA or the Friedman test, with the Bonferroni post-test, was used.

Results: Fifteen patients (4.5±2.6y, 80% male, 40% had structural/metabolic etiology epilepsy, 40% had unknown etiology epilepsy, and 20% had genetic etiology epilepsy). At T0, patients had a median of 9 seizures/day (min.=0–max.=60), at T1 there was a reduction to 2 seizures (min.=0– max.=15), and at T2 to 1 daily seizure (min.=0– max.=20) (p<0.01). Thus, MKD promoted a 66.7% reduction in seizures throughout the follow-up. As an adverse effect, triglycerides increase (T0=70.4±33.5mg/dL, T2 =110.0±57.0mg/dL, p=0.03). A decrease in ALP was noted (T0=199.8±64.5U/L, T2=133.3± 38.6U/L, p=0,01), without clinically relevant changes in the other liver enzymes. As expected, there was a decrease in blood glucose levels (T0=82.8±14.6mg/dL;T2=72.9±9.9mg/dL, p=0.02). Ultrasonography revealed the presence of a regular liver surface, homogenous liver echotexture, usual echogenicity, absence of attenuation, and absence of liver steatosis in all patients throughout the intervention.

Conclusion: Six months of MKD was effective in reducing seizures in children with refractory epilepsy, but induced hypertriglyceridemia without significant changes in the incidence of liver steatosis. 

Disclosure of Interest: None declared