Abstract：
Ketogenic diet Therapy (KDT) has been reported as a possible beneficial management strategy for controlling seizures in infants aged <2 years, but the safety and efficacy of this therapy remain to be investigated. We investigated the achievability, tolerability, efficacy, and safety of KDT for patients under 2 years old.
Infants younger than 2 years old with pharmacoresistant epilepsy were enrolled in this prospective study. We divided cases into three age groups: I) neonates; II) infants aged 1-12 months; III) infants aged 12-24 months. KDT initiation protocol were administration through parenteral route, enteral route or oral feeding. Seizure reduction rate, physical growth, and adverse effects were assessed at monthly visit.
Thirteen patients who completed 6 months of KDT were recruited. There was one neonate in group I, 9 infants in group II, and 3 infants in group III. Eleven of them (11/13, 84.6%) were responders to KDT. All infants with underlying genetic etiology were seizure free after treating with KDT. The starting keto ratio was 1.1 mmol/L in group I, 2.3 mmol/L in group II, and 2.8 mmol/L in group III, which gradually approached 3:1-4:1 over 5-7 days. There were no symptomatic adverse effects or growth retardation in any of the study subjects.
KDT is a promising alternative therapy with high feasibility, safety, and efficacy for pharmacoresistant epilepsy in infants under 2 years old, especially for those with genetic etiology. The starting keto ratio should be lower, and the keto ratio titration period should be longer than for children older than 2 years.
Infants younger than 2 years old with pharmacoresistant epilepsy were enrolled in this prospective study. We divided cases into three age groups: I) neonates; II) infants aged 1-12 months; III) infants aged 12-24 months. KDT initiation protocol were administration through parenteral route, enteral route or oral feeding. Seizure reduction rate, physical growth, and adverse effects were assessed at monthly visit.
Thirteen patients who completed 6 months of KDT were recruited. There was one neonate in group I, 9 infants in group II, and 3 infants in group III. Eleven of them (11/13, 84.6%) were responders to KDT. All infants with underlying genetic etiology were seizure free after treating with KDT. The starting keto ratio was 1.1 mmol/L in group I, 2.3 mmol/L in group II, and 2.8 mmol/L in group III, which gradually approached 3:1-4:1 over 5-7 days. There were no symptomatic adverse effects or growth retardation in any of the study subjects.
KDT is a promising alternative therapy with high feasibility, safety, and efficacy for pharmacoresistant epilepsy in infants under 2 years old, especially for those with genetic etiology. The starting keto ratio should be lower, and the keto ratio titration period should be longer than for children older than 2 years.
摘要：
背景：生酮饮食疗法（KDT）已被报道为控制2岁以下婴儿癫痫发作的可能有益的管理策略，但该疗法的安全性和有效性仍有待研究.我们研究了可实现性，耐受性,功效,以及2岁以下患者使用KDT的安全性。
方法：这项前瞻性研究纳入了年龄小于2岁的患有药物抗性癫痫的婴儿。我们将病例分为三个年龄组：I）新生儿；II）1-12个月的婴儿；III）12-24个月的婴儿。KDT起始方案是通过肠胃外途径给药，肠内途径或口服喂养。癫痫发作减少率，身体生长，不良反应在每月访视时进行评估.
结果：招募了13名完成6个月KDT治疗的患者。第一组有一个新生儿，第二组9名婴儿，第三组3名婴儿。其中11人(11/13，84.6%)是KDT的应答者。所有具有潜在遗传病因的婴儿在接受KDT治疗后均无癫痫发作。第一组的起始酮比为1.1mmol/L,II组2.3mmol/L，III组中为2.8mmol/L，在5-7天内逐渐接近3：1-4：1。在任何研究受试者中都没有症状不良反应或生长迟缓。
结论：KDT是一种有前途的替代疗法，具有很高的可行性，安全,2岁以下婴儿药物耐药癫痫的疗效，尤其是那些有遗传病因的人。起始酮比应较低，酮比滴定期应长于2岁以上儿童。
方法：这项前瞻性研究纳入了年龄小于2岁的患有药物抗性癫痫的婴儿。我们将病例分为三个年龄组：I）新生儿；II）1-12个月的婴儿；III）12-24个月的婴儿。KDT起始方案是通过肠胃外途径给药，肠内途径或口服喂养。癫痫发作减少率，身体生长，不良反应在每月访视时进行评估.
结果：招募了13名完成6个月KDT治疗的患者。第一组有一个新生儿，第二组9名婴儿，第三组3名婴儿。其中11人(11/13，84.6%)是KDT的应答者。所有具有潜在遗传病因的婴儿在接受KDT治疗后均无癫痫发作。第一组的起始酮比为1.1mmol/L,II组2.3mmol/L，III组中为2.8mmol/L，在5-7天内逐渐接近3：1-4：1。在任何研究受试者中都没有症状不良反应或生长迟缓。
结论：KDT是一种有前途的替代疗法，具有很高的可行性，安全,2岁以下婴儿药物耐药癫痫的疗效，尤其是那些有遗传病因的人。起始酮比应较低，酮比滴定期应长于2岁以上儿童。
