Efficacy and tolerability of ketogenic diet therapy in 55 Chinese children with drug-resistant epilepsy in Northwest China

Background Due to the tradition of carbohydrate-rich diet, challenges exist for ketogenic diet (KD) implementation in Northwest China. This study was aimed to investigate the efficacy and tolerability of KD therapy administered with gradual initiation protocols in Chinese children with pharmacoresistant epilepsy in Northwest China. Methods In this single-center study, 55 children with drug-resistant epilepsy were enrolled from June 2013 to June 2019. The efficacy of KD, reasons for discontinuation, duration of retention and rate of adverse events were evaluated. Results Fifty-five children aged from 2.2 months to 169.7 months were included, with a median age at KD initiation of 14.1 months, and 32 cases (58.2%) responded to the diet therapy at the last contact. The responder rates were 16.4% (9/55), 36.4% (20/55), 30.9% (17/55), 27.3% (15/55) at 1, 3, 6 and 12 months, respectively. Univariate analysis indicated that the duration of epilepsy and the duration of KD therapy were predictors for KD effectiveness. Poor compliance and lack of response were main reasons for discontinuation of KD. There are a few side effects of KD, most of which were minor. Conclusions The KD therapy with a gradual-initiation protocol is effective and tolerable for children with drug-resistant epilepsy in Northwest China. Early start of KD and KD duration of more than 6 months may be predictive factors for KD efficacy.