One Center's Experience With Outpatient Initiation of Ketogenic Therapy in Infants 18 Months or Younger

BackgroundKetogenic therapy is an adjunct therapy for drug-resistant epilepsy and is usually initiated while patients are hospitalized. Phoenix Children's has experience with safe and effective outpatient initiation of ketogenic therapy in infants 18 months of age and younger.MethodsA retrospective chart review of 37 infants who initiated ketogenic therapy from 2011 to 2022 was performed.ResultsThe median (range) age of patients was 10 (2-18) months. Ketogenic therapy reduced seizures by at least 50% in 23 of 37 patients (62%). Adverse effects were reported in 32 of 37 patients (86%), including constipation, vomiting, and acidosis. Of 32 patients who developed adverse effects, all were managed as outpatients, and 4 (12%) required hospitalization to manage additional adverse effects.ConclusionThe results suggest that outpatient initiation of ketogenic therapy for infants ≤18 months of age was safe and efficacious in this cohort.