Study of the Cardiovascular Effects of Ketogenic Diet Regimen in Epileptic Children

Abstract Background Ketogenic diet therapies (KDT) are well-established, non-pharmacologic treatments used for children with drug resistant epilepsy. Cardiac abnormalities have been reported in children on the KD, including cardiomyopathy and prolonged QT interval. ECG should be considered in any child with history of heart disease before starting ketogenic diet therapy. Aim of the Work To evaluate the impact of ketogenic diet therapy on the cardiovascular structure, diastolic function as well as assessment of carotid intima-media thickness for a group of children with drug resistant epilepsy. Patients and Methods This was a Prospective cohort study that was carried out at Ketogenic Diet Clinic and Epilepsy Clinic, Children’s Hospital, Faculty of Medicine, Ain Shams University on thirty infants and children with drug resistant epilepsy (DRE) aged from 6 months to 16 years old. Results There was no statistically significant difference in echocardiographic parameters, carotid intima media thickness (CIMT) or ECG after 6 months of Ketogenic diet therapy KDT inspite of hyperlipidemia and ketosis yet statistically significant negative correlation was found between serum cholesterol and triglyceride with ejection fraction and fractional shortening which could be explained by increased blood viscosity associated with hyperlipidemia. There was statistically significant decrease in seizure frequency and number of anti-epileptic drugs. There was significant increase in almost all anthropometric measurements, lipid profile and serum ketones. While no significant differences found in vital data, blood cells. Conclusion The six months ketogenic diet regimen appears to have no disturbing effect on the cardiovascular structure, diastolic functions as well as carotid intima-media thickness in children with drug resistant epilepsy inspite of hyperlipidemia. Cardiovascular monitoring is recommended for patients undergoing ketogenic diet therapy and further research is needed to fully understand the potential risks and benefits of this treatment on a larger population and longer period schedules.