Ketogenic diet in Indian children with uncontrolled epilepsy.

OBJECTIVE: To evaluate the efficacy of the ketogenic diet in Indian children with uncontrolled epilepsy. STUDY DESIGN: Prospective observational study. SETTING: Hospital based. PATIENTS: 105 children (age 4 months to 18 years) with uncontrolled epilepsy enrolled in the ketogenic diet program over a period of 9 years and followed up for 25.7+/- 20.3 months (median:17 months) on the ketogenic diet. MAIN OUTCOME MEASURES: Reduction in seizure frequency and comparison of improvement in two main groups of epilepsies, namely epileptic encephalopathies and localization related epilepsies. RESULTS: Thirty seven (35%) out of 105 children dropped out of the study and 68 remained on the diet. Thirty nine (37%) achieved 100% control, 23 (22%) achieved between 90 and 99% control, 7 (6.8%) achieved between 75 and 90% control, and 16 (15.2%) achieved between 50 and 75% control. Twenty (19%) achieved less than 50% control. Epileptic encephalopathies had a better response than localization related epilepsies. CONCLUSION: The Indian version of ketogenic diet used is well tolerated and efficacious in controlling difficult-to-control epilepsy in children. Epileptic encephalopathies respond better than localization related epilepsies.