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Effectiveness, retention, and safety of modified ketogenic diet in adults with epilepsy at a tertiary-care centre in the UK

Green, SF; Nguyen, P; Kaalund-Hansen, K; Rajakulendran, S; Murphy, E; (2020) Effectiveness, retention, and safety of modified ketogenic diet in adults with epilepsy at a tertiary-care centre in the UK. Journal of Neurology , 267 pp. 1171-1178. 10.1007/s00415-019-09658-6. Green open access

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Abstract

With the rising demand for ketogenic diet therapy in adult epilepsy, there is a need for research describing the real-life efectiveness, retention, and safety of relevant services. In this 1-year prospective cohort study we present outcomes of the frst 100 referrals for modifed ketogenic diet (MKD) at the UK’s largest tertiary-care epilepsy centre, where patients received dietetic review up to twice per week. Of the frst 100 referrals, 42 (31 females, 11 males; mean age 36.8 [SD±11.4 years]) commenced MKD, having used a mean of 4 (SD±3) previous antiepileptic drugs. Retention rates were: 60% at 3 months, 43% at 6 months, and 29% at 12 months. 60% of patients reported an improvement in seizure frequency, 38% reported a>50% reduction, and 13% reported a period of seizure freedom; 30% reported a worsening in seizure frequency at some point during MKD therapy. The most common reasons for discontinuing MKD were side efects and diet restrictiveness. The most common side efects were weight loss, gastrointestinal symptoms and low mood. The likelihood of discontinuing MKD was signifcantly decreased by experiencing an improvement in seizure frequency (p≤0.001). This study demonstrates that MKD can be efective in adults, although, even with regular dietetic support, retention rates remain low, and periods of worsening seizure frequency are common.

Type: Article
Title: Effectiveness, retention, and safety of modified ketogenic diet in adults with epilepsy at a tertiary-care centre in the UK
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00415-019-09658-6
Publisher version: https://doi.org/10.1007/s00415-019-09658-6
Language: English
Additional information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Keywords: Epilepsy · Seizures · Ketogenic diet · Ketones · Adult
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/10101864
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