Ketogenic diet in pediatric patients with refractory focal status epilepticus

Summary The ketogenic diet (KD) has been used as an alternative treatment for patients with refractory status epilepticus (SE). Purpose In this retrospective study we assess the efficacy and tolerability of the KD in patients with refractory SE. Methods Between March 1, 2010 and January 1, 2014, 10 patients who met the diagnostic criteria of refractory SE seen at our department were placed on the KD and followed for a minimum of 6 months. Results Ketonuria was reached within 2–4 days (mean 3 days) for all patients. Seizures stopped in two patients and five patients had a 50–75% seizure reduction within 2–5 days (mean 2.5 days) following the onset of ketonuria and within 5–7 days (mean 5 days) following the onset of the diet. Three patients had a Conclusion The KD is an effective and well-tolerated treatment option for patients with refractory SE. In patients with focal SE secondary to inflammatory or probably inflammatory diseases, the KD should be considered earlier in the course of the treatment.