Non-pharma therapies may offer seizure relief for children with epilepsy

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Non-pharmaceutical treatments improved 4 cognitive and behavioral domains in children with epilepsy.
Non-pharmaceutical treatments improved 4 cognitive and behavioral domains in children with epilepsy.

(HealthDay News) — Non-pharmaceutical therapies may offer seizure relief for children with epilepsy, and slow introduction of the ketogenic diet (KD) is effective, according to 2 studies presented at the annual meeting of the American Epilepsy Society, held from Dec. 1 to 5 in Washington, DC.

Miriam Jackson, RN, from the Dell Children's Medical Center of Central Texas in Austin, and colleagues conducted telephone interviews with parents of 210 patients with pharmacoresistent epilepsy who had 292 treatment modalities (150 vagal nerve stimulator [VNS] implantation, 44 corpus callosotomy [CC], and 98 KD). The researchers found that the improvement across 4 cognitive and behavioral domains ranged from 33.3 to 49.3% for VNS, from 40.9 to 59.1% for CC, and from 34.7 to 57.1%  for KD. A reduction of ≥50% in atonic and/or other generalized seizures occurred in 51.7, 53.5, and 62.5% of VNS, CC, and KD groups, respectively.

Rajesh RamachandranNair, MBBS, from McMaster Children's Hospital in Hamilton, Canada, and colleagues examined seizure outcome at 6 months following slow initiation of KD in 40 children. The diet was initiated at a very low ratio (0.6 to 1:1) and was increased gradually depending on the tolerability and desired seizure control. The researchers observed a decrease in seizure frequency from a median of 90 to 25/month. Overall, 47.5% of patients had >50% reduction in seizure frequency at 6 months.

"Changing the way we implement the diet from the most strict to a more liberalized form is more family- and child-friendly and it still works," RamachandranNair said in a statement.

References

  1. Jackson M, Mccartney M, Moore E, et al. Seizure control and quality of life in children with epilepsy after vagus nerve stimulator placement, corpus callosotomy, or ketogenic diet initiation. Presented at: 2017 American Epilepsy Society Annual Meeting. December 1-5, 2017; Washington, DC. Abstract 3.178. 
  2. RamachandranNair R, Nandeesha N, Chen Z, and Hassan-Ali M. Good seizure control can be achieved at low ratios by slow outpatient titration of ketogenic diet (KD). Presented at: 2017 American Epilepsy Society Annual Meeting. December 1-5, 2017; Washington, DC. Abstract 3.332
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