The ketogenic diet: A 3-to 6-year follow-up of 150 children enrolled prospectively

Objective. To document the long-term outcome of the 83 children with diffic ult-to-control seizures who were enrolled prospectively in a study of the e fficacy of the ketogenic diet and who had remained on the diet for 1 year. Methods. A total of 150 consecutive children were entered prospectively int o a study of the ketogenic diet's efficacy and tolerability. Three to 6 yea rs after diet initiation, all 150 families were sent a survey inquiring abo ut their child's current health status, seizure frequency, and current anti convulsant medications. They were asked about their experience with the die t and reasons for discontinuation. Several telephone attempts were made to contact those who did not respond to the written questionnaire. Responses w ere entered in an Access database and analyzed. Results. In 1999, 3 to 6 years after initiating the diet, 107 of 150 famili es responded to a questionnaire. Thirty-five additional families were inter viewed by telephone, 4 were lost to follow-up, and 4 children had died, unr elated to the diet. Of the original 150 patient cohort, 20 (13%) were seizu re-free and an additional 21 (14%) had a 90% to 99% decrease in their seizu res. Twenty-nine were free of medications, and 28 were on only 1 medication ; 15 remained on the diet. There were no known cardiac complications. Conclusion. Three to 6 years after initiation, the ketogenic diet had prove n to be effective in the control of difficult-to-control seizures in childr en. The diet often allows decrease or discontinuation of medication. It is more effective than many of the newer anticonvulsants and is well-tolerated when it is effective.