Non-Drug Options Provide Seizure Relief in Children
MONDAY, Dec. 4, 2017 -- Non-pharmaceutical therapies may offer seizure relief for children with epilepsy, and slow introduction of the ketogenic diet (KD) is effective, according to two studies presented at the annual meeting of the American Epilepsy Society, held from Dec. 1 to 5 in Washington, D.C.
Miriam Jackson, R.N., from the Dell Children's Medical Center of Central Texas in Austin, and colleagues conducted telephone interviews with parents of 210 patients with pharmacoresistent epilepsy who had 292 treatment modalities (150 vagal nerve stimulator [VNS] implantation, 44 corpus callosotomy [CC], and 98 KD). The researchers found that the improvement across four cognitive and behavioral domains ranged from 33.3 to 49.3 percent for VNS, from 40.9 to 59.1 percent for CC, and from 34.7 to 57.1 percent for KD. A reduction of ≥50 percent in atonic and/or other generalized seizures occurred in 51.7, 53.5, and 62.5 percent of VNS, CC, and KD groups, respectively.
Rajesh RamachandranNair, M.B.B.S., from McMaster Children's Hospital in Hamilton, Canada, and colleagues examined seizure outcome at six months following slow initiation of KD in 40 children. The diet was initiated at a very low ratio (0.6 to 1:1) and was increased gradually depending on the tolerability and desired seizure control. The researchers observed a decrease in seizure frequency from a median of 90 to 25/month. Overall, 47.5 percent of patients had >50 percent reduction in seizure frequency at six months.
"Changing the way we implement the diet from the most strict to a more liberalized form is more family- and child-friendly and it still works," RamachandranNair said in a statement.
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Posted: December 2017
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