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Neuropediatrics 2023; 54(05): 315-321
DOI: 10.1055/s-0043-1769505
Original Article

Ketogenic Diet in Neonates with Drug-Resistant Epilepsy: Efficacy and Side Effects—A Single Center's Initial Experience

Raffaele Falsaperla
1   Neonatal Intensive Care Unit and Neonatal Accompaniment Unit, Azienda Ospedaliero-Universitaria Policlinico “Rodolico-San Marco,” San Marco Hospital, University of Catania, Catania, Italy
2   Unit of Pediatrics and Pediatric Emergency, Azienda Ospedaliero-Universitaria Policlinico, “Rodolico-San Marco,” San Marco Hospital, Catania, Italy
,
Vincenzo Sortino
2   Unit of Pediatrics and Pediatric Emergency, Azienda Ospedaliero-Universitaria Policlinico, “Rodolico-San Marco,” San Marco Hospital, Catania, Italy
3   Postgraduate Training Program in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
,
Ausilia Desiree Collotta
2   Unit of Pediatrics and Pediatric Emergency, Azienda Ospedaliero-Universitaria Policlinico, “Rodolico-San Marco,” San Marco Hospital, Catania, Italy
3   Postgraduate Training Program in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
,
Grete Francesca Privitera
4   Unit of Math and Comp Science, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
,
Antonio Palmeri
3   Postgraduate Training Program in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
,
Laura Mauceri
1   Neonatal Intensive Care Unit and Neonatal Accompaniment Unit, Azienda Ospedaliero-Universitaria Policlinico “Rodolico-San Marco,” San Marco Hospital, University of Catania, Catania, Italy
,
Martino Ruggieri
5   Unit of Clinical Pediatrics and Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Policlinico Hospital, Catania, Italy
› Author Affiliations Funding None.
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Abstract

Background For patients with pharmacoresistant epilepsy, a therapeutic option is ketogenic diet. Currently, data on young infants are scarce, particularly during hospitalization in the neonatal intensive care unit (NICU).

Objective The aim of the present study was to evaluate the short-term (3-month) efficacy and side effects of ketogenic diet in infants with “drugs-resistant” epilepsy treated during NICU stay.

Methods This retrospective study included infants aged under 2 months started on ketogenic diet during NICU hospitalization to treat drug-resistant epilepsy from April 2018 to November 2022.

Results Thirteen term-born infants were included, three (23.1%) of whom were excluded because they did not respond to the ketogenic diet. Finally, we included 10 infants. Six (60%) patients took three antiepileptics before starting the ketogenic diet, while four (40%) took more drugs. Diet had a good response in four (40%) patients. In four patients, the ketogenic diet was suspended because of the onset of serious side effects. The emetic levels of sodium, potassium, and chlorine, pH, and onset of diarrhea, constipation, and gastroesophageal reflux showed significant differences. Ketonuria was higher and blood pH lower in the group that took more than three drugs than in the group taking fewer than three drugs.

Conclusion The ketogenic diet is efficacious and safe in infants, but the early and aggressive management of adverse reactions is important to improve the safety and effectiveness of the ketogenic treatment.

Keywords

ketogenic diet - neonates - drug-resistant epilepsy

Authors' Contributions

R.F. and M.R. conceived and designed the study. V.S., A.D.C., A.P., and L.M. acquired the data. G.F.P. performed the statistical analysis. All authors have interpreted the data and approved the submitted version.




Publication History

Received: 15 January 2023

Accepted: 18 April 2023

Article published online:
15 June 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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