Etiology of ketogenic diet failure in patients with drug resistant epilepsy

Abstract

Drug-resistant epilepsy is an important global challenge that affects the well-being of patients. Antiepileptic drugs are often unable to effectively control seizures in people with drug-resistant epilepsy. The ketogenic diet has emerged as a valuable therapeutic approach for drug-resistant epilepsy. Different types of ketogenic diets have been shown to be effective in controlling seizures. In this regard, in the present study, the causes of ketogenic diet failure in patients with drug-resistant epilepsy were investigated. Methods: This study is a descriptive cross-sectional retrospective study in which 31 children with epilepsy resistant to anticonvulsant drug treatment who were treated with classical ketogenic diet or Atkins patients who reported less than a 50% reduction in the number and duration of seizures (diet failure) were studied. For these patients, a questionnaire containing demographic information, socio-economic status, EEG findings, type of epilepsy syndrome, developmental delay, ketonuria, etc. was completed from the information in their file and through a phone call with the parents. The data will be analyzed. Results: The average age of the children was 44.68 ± 22.305 months, of which 15 (48.4%) were boys and 16 (51.6%) were girls. The average age of onset of seizures in children was 6.16 ± 6.856 months, the number of seizures per day was 5.16 ± 3.652 times. The most frequent occurrence of seizures was during wakefulness (18 people, 58.1%). The generalized type was the most frequent in children (28 people, 90.3%). In terms of semiology, the highest frequency was related to tonic type (8 people, 25.8%) and then myoclonic (7 people, 6.22%). The highest frequency of diagnosis was related to symptomatic epilepsy (11 people, 35.5%) and then cytogenic epilepsy (8 people, 25.8%). The highest number of drugs used in children was 3 drugs, which was seen in 16 (51.6%) patients. 29 people used 93.5% of the prescribed medicines correctly and on time, and in 29 people, 93.5% of the medicine was tolerated by the child. In 3 (9.7%) participants, there was a history of taking other drugs chronically and at the same time. The rate of ketonuria in the majority of patients (26 people, 83.9 percent) was appropriate, and only in 5 people (16.1 percent), the rate of ketonuria was not appropriate. Ketogenic diet tolerance was good in the majority of patients (22 patients, 71%). In 18 patients (58.1%), parents had good education, and in 10 patients (32.3%), parents had average education. The majority of patients (26 people, 83.9%) were on ketogenic diet without complications. Also, in the majority of patients (17 equal to 54/8), parents did not cooperate properly (Table 4-10).