A multicenter study of the efficacy of the ketogenic diet

Eileen P G Vining, John M. Freeman, Karen R. Ballaban-Gil, Carol S. Camfield, Peter R. Camfield, Gregory L. Holmes, Shlomo Shinnar, Robert Shuman, Edwin Trevathan, James W. Wheless

Research output: Contribution to journalArticle

284 Citations (Scopus)

Abstract

Objective: To determine the efficacy of the ketogenic diet in multiple centers. Design: A prospective study of the change in frequency of seizures in 51 children with intractable seizures who were treated with the ketogenic diet. Setting: Patients were enrolled from the clinical practices of 7 sites. The diet was initiated in-hospital and the patients were followed up for at least 6 months. Patients: Fifty-one children, aged 1 to 8 years, with more than 10 seizures per week, whose electroencephalogram showed generalized epileptiform abnormalities or multifocal spikes, and who had failed results when taking at least 2 appropriate anti-epileptic drugs. Intervention: The children were hospitalized, fasted, and a 4:1 ketogenic diet was initiated and maintained. Main Outcome Measures: Frequency of seizures was documented from parental calendars and efficacy was compared with prediet baseline after 3, 6, and 12 months. The children were categorized as free of seizures, greater than 90% reduction, 50% to 90% reduction, or lower than 50% reduction in frequency of seizures. Results: Eighty-eight percent of all children initiating the diet remained on it at 3 months, 69% remained on it at 6 months, and 47% remained on it at 1 year. Three months after initiating the diet, frequency of seizures was decreased to greater than 50% in 54%. At 6 months, 28 (55%) of the 51 initiating the diet had at least a 50% decrease from baseline, and at 1 year, 40% of those starting the diet had a greater than 50% decrease in seizures. Five patients (10%) were free of seizures at 1 year. Age, sex, principal seizure type, and electroencephalogram were not statistically related to outcome. Conclusion: The ketogenic diet is effective in substantially decreasing difficult-to-control seizures and can successfully be administered in a wide variety of settings.

Original languageEnglish (US)
Pages (from-to)1433-1437
Number of pages5
JournalArchives of Neurology
Volume55
Issue number11
StatePublished - Nov 1998

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Ketogenic Diet
Multicenter Studies
Seizures
Diet
Electroencephalography
Efficacy
Hospitalized Child

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Vining, E. P. G., Freeman, J. M., Ballaban-Gil, K. R., Camfield, C. S., Camfield, P. R., Holmes, G. L., ... Wheless, J. W. (1998). A multicenter study of the efficacy of the ketogenic diet. Archives of Neurology, 55(11), 1433-1437.

A multicenter study of the efficacy of the ketogenic diet. / Vining, Eileen P G; Freeman, John M.; Ballaban-Gil, Karen R.; Camfield, Carol S.; Camfield, Peter R.; Holmes, Gregory L.; Shinnar, Shlomo; Shuman, Robert; Trevathan, Edwin; Wheless, James W.

In: Archives of Neurology, Vol. 55, No. 11, 11.1998, p. 1433-1437.

Research output: Contribution to journalArticle

Vining, EPG, Freeman, JM, Ballaban-Gil, KR, Camfield, CS, Camfield, PR, Holmes, GL, Shinnar, S, Shuman, R, Trevathan, E & Wheless, JW 1998, 'A multicenter study of the efficacy of the ketogenic diet', Archives of Neurology, vol. 55, no. 11, pp. 1433-1437.
Vining EPG, Freeman JM, Ballaban-Gil KR, Camfield CS, Camfield PR, Holmes GL et al. A multicenter study of the efficacy of the ketogenic diet. Archives of Neurology. 1998 Nov;55(11):1433-1437.
Vining, Eileen P G ; Freeman, John M. ; Ballaban-Gil, Karen R. ; Camfield, Carol S. ; Camfield, Peter R. ; Holmes, Gregory L. ; Shinnar, Shlomo ; Shuman, Robert ; Trevathan, Edwin ; Wheless, James W. / A multicenter study of the efficacy of the ketogenic diet. In: Archives of Neurology. 1998 ; Vol. 55, No. 11. pp. 1433-1437.
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title = "A multicenter study of the efficacy of the ketogenic diet",
abstract = "Objective: To determine the efficacy of the ketogenic diet in multiple centers. Design: A prospective study of the change in frequency of seizures in 51 children with intractable seizures who were treated with the ketogenic diet. Setting: Patients were enrolled from the clinical practices of 7 sites. The diet was initiated in-hospital and the patients were followed up for at least 6 months. Patients: Fifty-one children, aged 1 to 8 years, with more than 10 seizures per week, whose electroencephalogram showed generalized epileptiform abnormalities or multifocal spikes, and who had failed results when taking at least 2 appropriate anti-epileptic drugs. Intervention: The children were hospitalized, fasted, and a 4:1 ketogenic diet was initiated and maintained. Main Outcome Measures: Frequency of seizures was documented from parental calendars and efficacy was compared with prediet baseline after 3, 6, and 12 months. The children were categorized as free of seizures, greater than 90{\%} reduction, 50{\%} to 90{\%} reduction, or lower than 50{\%} reduction in frequency of seizures. Results: Eighty-eight percent of all children initiating the diet remained on it at 3 months, 69{\%} remained on it at 6 months, and 47{\%} remained on it at 1 year. Three months after initiating the diet, frequency of seizures was decreased to greater than 50{\%} in 54{\%}. At 6 months, 28 (55{\%}) of the 51 initiating the diet had at least a 50{\%} decrease from baseline, and at 1 year, 40{\%} of those starting the diet had a greater than 50{\%} decrease in seizures. Five patients (10{\%}) were free of seizures at 1 year. Age, sex, principal seizure type, and electroencephalogram were not statistically related to outcome. Conclusion: The ketogenic diet is effective in substantially decreasing difficult-to-control seizures and can successfully be administered in a wide variety of settings.",
author = "Vining, {Eileen P G} and Freeman, {John M.} and Ballaban-Gil, {Karen R.} and Camfield, {Carol S.} and Camfield, {Peter R.} and Holmes, {Gregory L.} and Shlomo Shinnar and Robert Shuman and Edwin Trevathan and Wheless, {James W.}",
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AU - Holmes, Gregory L.

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N2 - Objective: To determine the efficacy of the ketogenic diet in multiple centers. Design: A prospective study of the change in frequency of seizures in 51 children with intractable seizures who were treated with the ketogenic diet. Setting: Patients were enrolled from the clinical practices of 7 sites. The diet was initiated in-hospital and the patients were followed up for at least 6 months. Patients: Fifty-one children, aged 1 to 8 years, with more than 10 seizures per week, whose electroencephalogram showed generalized epileptiform abnormalities or multifocal spikes, and who had failed results when taking at least 2 appropriate anti-epileptic drugs. Intervention: The children were hospitalized, fasted, and a 4:1 ketogenic diet was initiated and maintained. Main Outcome Measures: Frequency of seizures was documented from parental calendars and efficacy was compared with prediet baseline after 3, 6, and 12 months. The children were categorized as free of seizures, greater than 90% reduction, 50% to 90% reduction, or lower than 50% reduction in frequency of seizures. Results: Eighty-eight percent of all children initiating the diet remained on it at 3 months, 69% remained on it at 6 months, and 47% remained on it at 1 year. Three months after initiating the diet, frequency of seizures was decreased to greater than 50% in 54%. At 6 months, 28 (55%) of the 51 initiating the diet had at least a 50% decrease from baseline, and at 1 year, 40% of those starting the diet had a greater than 50% decrease in seizures. Five patients (10%) were free of seizures at 1 year. Age, sex, principal seizure type, and electroencephalogram were not statistically related to outcome. Conclusion: The ketogenic diet is effective in substantially decreasing difficult-to-control seizures and can successfully be administered in a wide variety of settings.

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