Tabriz University of Medical Sciences Medical Journal of Tabriz University of Medical Sciences 2783-2031 31 2 2009 06 22 The Ketogenic Diet for Refractory Childhood Epilepsy 15 20 EN Mohammad Barzegar Alireza Ostad Rahimi Skoofeh Eslampour Shahla Shahbazi Journal Article 2009 10 31 Background and Objectives: The Ketogenic diet (KD) is a high fat, low protein and low carbohydrate, which controls refractory epilepsy. This prospective study sought to determine the ketogenic diet's effectiveness in children with refractory (to medication) epilepsy. Materials & Methods: Forty three children, ages 2 to 14 years were treated with the classical KD from 2002 to 2006. Response to treatment (reduction of seizure frequency > 50 %) tolerability and adverse events were analyzed. Results: Forty three children (mean age 5.8 years old), averaged 30 seizures per month before KD, despite on exposure to a mean 6.6 antiepileptic medications were treated with KD. At one month 93%, at 3 months 74%, at 6 months 51% and at 12 months 40% of patients remained on diet, 35% maintained the KD >12 months. At one month 77%, at 3 months 65%, at 6 months 44% and at 12 months 35% of patients showed a reduction of seizure frequency of >50%. Age, sex, seizure type and etiology did not predict response. Exposure more antiepileptic drugs before KD was with poor response at 12 months (P=0.007). High frequency of seizures before diet showed better response at 12 months (P=0.041). Most complications were mild and transient, but in 6 patients (14%) leads to discontinue the KD. Conclusion: The KD is an effective and safe treatment for children with refractory epilepsy.