Ketogenic diet in Indian children with uncontrolled epilepsy.

OBJECTIVE To evaluate the efficacy of the ketogenic diet in Indian children with uncontrolled epilepsy. STUDY DESIGN Prospective observational study. SETTING Hospital based. PATIENTS 105 children (age 4 months to 18 years) with uncontrolled epilepsy enrolled in the ketogenic diet program over a period of 9 years and followed up for 25.7+/- 20.3 months (median:17 months) on the ketogenic diet. MAIN OUTCOME MEASURES Reduction in seizure frequency and comparison of improvement in two main groups of epilepsies, namely epileptic encephalopathies and localization related epilepsies. RESULTS Thirty seven (35%) out of 105 children dropped out of the study and 68 remained on the diet. Thirty nine (37%) achieved 100% control, 23 (22%) achieved between 90 and 99% control, 7 (6.8%) achieved between 75 and 90% control, and 16 (15.2%) achieved between 50 and 75% control. Twenty (19%) achieved less than 50% control. Epileptic encephalopathies had a better response than localization related epilepsies. CONCLUSION The Indian version of ketogenic diet used is well tolerated and efficacious in controlling difficult-to-control epilepsy in children. Epileptic encephalopathies respond better than localization related epilepsies.