AI Article Synopsis
- The ideal weaning speed for the ketogenic diet and its impact on seizures remains uncertain, prompting a study of children who discontinued the diet between 2000 and 2010 at Johns Hopkins Hospital.
- Children with longer diet durations and lower seizure frequencies tended to wean off the diet more slowly, but the speed of discontinuation did not significantly affect seizure worsening rates overall.
- Notably, those with a 50-99% reduction in seizures who were taking more anticonvulsants faced a higher risk of worsening seizures, indicating that quick discontinuation of the diet is generally safe, especially when done over several weeks rather than months.
Article Abstract
It is unclear what the ideal weaning speed of the ketogenic diet should be and the resultant risk of seizure worsening. A retrospective chart review was performed of children who discontinued the ketogenic diet at Johns Hopkins Hospital from January 2000 to June 2010. Speed of discontinuation was categorized into immediate (<1 week), quick (1-6 weeks), or slow (>6 weeks) rates. One hundred and eighty-three children were identified. Children with both a longer diet duration (p=0.004) and lower seizure frequency (p<0.001) were weaned more slowly by our group. There was no significant difference in the incidence of seizures worsening between discontinuation rates. However, there was an increased risk of seizures worsening in those specifically with a 50-99% seizure reduction (30% vs. 8%, p<0.0001) and for that level of seizure improvement, in those who were receiving more anticonvulsants (1.4 vs. 0.8, p=0.01). In summary, there does not appear to be an increased risk of seizure exacerbation with rapid ketogenic diet discontinuations. Those who improved 50-99% and were receiving more anticonvulsants were at the highest risk overall. Discontinuing the ketogenic diet over weeks rather than months appears safe.
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| http://dx.doi.org/10.1016/j.eplepsyres.2011.04.003 | DOI Listing |
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