P.077 Response to the ketogenic diet in refractory epileptic spasms at BC Children’s Hospital

Background: Epileptic spasms (ES) are a devastating seizure type with poor neurodevelopmental outcome; 1/3 resistant to treatment first line therapies. Recently attention has been drawn the ketogenic diet (KD) as potentially effective therapy, though data regarding optimal time of initiation, and its sustained effectiveness, lacking. Methods: Retrospective chart review all patients ES treated KD at BC Children’s Hospital between 2002 2020 (n=28) comparison spasm response based on age initiation in two groups: < 12 months (n=11) ≥ (n=17). Results: Comparing <12 groups showed: unknown etiology 9% vs 25%; freedom for 3 18% 41%; median was 2 6 weeks; relapse after period occurred 66% 70%. Conclusions: Although more children months, either group not KD. is recommended early therapy refractory ES, but this study suggests clinicians be aware limited efficacy long-term control must used other