Continuing Ketogenic Diet Therapy in Setting of Hypercalcemia

ObjectiveHypercalcemia is an uncommon, serious adverse effect of ketogenic diet therapy (KDT). This case highlights the management of hypercalcemia without discontinuing KDT.MethodsOur case study involves a retrospective chart analysis of one patient who developed hypercalcemia during KDT for seizure management.ResultsA 16-year-old male patient with cerebral palsy and intractable epilepsy acutely developed hypercalcemia after receiving KDT for 5 years. Despite hydration and discontinuation of calcium supplementation, hypercalcemia persisted. He was treated with pamidronate 0.3 mg/kg (dose renally adjusted) followed by 0.03 mg/kg intravenous zoledronate with reduction in serum calcium levels. KDT was continued.ConclusionsStandardized guidelines for managing hypercalcemia in adolescent patients with chronic KDT do not exist. More research is needed to guide management and monitoring while preserving seizure control with KDT.