Objective. To evaluate the effectiveness, tolerability, and adverse effects
of the ketogenic diet in infants with refractory epilepsy.
Methods. A retrospective review of 32 infants who had been treated with the
ketogenic diet at a large metropolitan institution.
Results. Most infants (71%) were able to maintain strong ketosis. The overa
ll effectiveness of the diet in infants was similar to that reported in the
literature for older children; 19.4% became seizure-free, and an additiona
l 35.5% had >50% reduction in seizure frequency. The diet was particularly
effective for patients with infantile spasms/myoclonic seizures. There were
concomitant reductions in antiepileptic medications. The majority of paren
ts reported improvements in seizure frequency and in their child's behavior
and function, particularly with respect to attention/alertness, activity l
evel, and socialization. The diet generally was well-tolerated, and 96.4% m
aintained appropriate growth parameters. Adverse events, all reversible and
occurring in one patient each, included renal stone, gastritis, ulcerative
colitis, alteration of mentation, and hyperlipidemia.
Conclusion. The ketogenic diet should be considered safe and effective trea
tment for infants with intractable seizures.