The Effect of Ketogenic Diet on Platelet Function in Children with Drug-Resistant Epilepsy

Abstract Background The ketogenic diet (KD) is a high-fat, adequate-protein, low-carbohydrate diet. As a special diet, the KD provides daily nutritional needs for children while controlling seizure and thus decreases the use of antiepileptic drugs. Several studies have reported pathological coagulation parameters and platelet abnormalities in patients treated with various antiseizure drugs (ASDs), especially for Valproic acid (VPA). The KD is frequently used in combination with antiepileptic drugs (AEDs), which may increase the risk of bleeding tendency, particularly with concomitant use of VPA or Topiramate. Objective To assess platelet count and function at baseline and six months after starting the KD in children with drug resistant epilepsy (DRE). Methods This prospective cohort study was conducted on 25 DRE children treated with KD for 6 months with age range of 4 months -14 years in the Children ‘s Hospital, Ain Shams University, Cairo, Egypt. They were assessed for anthropometric measurements, detailed medical history, history of bleeding symptoms, complete physical examination, neurological examination, and laboratory assessments as Complete Blood Count (CBC) and platelet function by ADP level at start and after 6 months of ketogenic diet treatment. Results There is no statistically significant change between platelet count and function initially and after 6 months of KD treatment, most of the patients (44%) were maintained on combination of Valproic acid and Levetiracetam and (40%) were maintained on triple therapy Valproic acid, Levetiracetam and Topiramate. Conclusion KD is an effective, safe, and tolerable therapy for children with DRE. No excessive bruising or other bleeding events were observed in any studied patient on KD.