The effectiveness of the ketogenic diet in treating refractory epilepsy: A study of different seizure forms

The objective of this study was to compare the efficacy of the ketogenic diet (KD) in patients with refractory epilepsy with different seizure forms and to further evaluate the correlation between seizure types and the efficacy of KD. In this prospective observational cohort study, consecutive children with refractory epilepsy (N = 72) treated with KD were recruited for follow-up. The children were divided into 2 groups: a nongeneralized seizure group and a full seizure group. Monthly seizure frequencies and seizure reduction rate after KDT 3 months and 6 months were compared between 2 groups. Follow-up results at 3 and 6 months showed a decrease in seizure frequency in both the nonprolific and full seizure groups, and the differences in seizure frequency from baseline were statistically significant in both the nonprolific and full seizure groups. After 3 months of KD treatment, the seizure frequency in the nongeneralized seizure group was notably lower than that in the full seizure group. However, after 6 months of KD treatment, there was no statistically significant difference between the seizure frequency of patients in the nongeneralized seizure group and those in the full seizure group. Further findings indicated a greater proportion of seizure reduction in the nongeneralized seizure group than in the full seizure group after 3 months of KD treatment. Statistically significant differences exist between the 2 groups (P＜.05). At the 6 months mark of KD treatment, no statistically significant disparities were observed in the seizure. Finally, this paper further proves the above point by comparing the number of patients who responded to KD through per-protocol population (PP) analysis and intention-to-treat analysis.