Yunjian Zhang1, Lifei Yu1, Yuanfeng Zhou1, Linmei Zhang1, Yi Wang1, Shuizhen Zhou2. 1. Department of Pediatric Neurology, Children's Hospital of Fudan University, China. 2. Department of Pediatric Neurology, Children's Hospital of Fudan University, China. Electronic address: szzhou@shmu.edu.cn.
Abstract
OBJECTIVE: The aim of this study was to evaluate the clinical efficacy and electroencephalographic (EEG) changes of West syndrome after ketogenic diet (KD) therapy and to explore the correlation of EEG features and clinical efficacy. PATIENTS AND METHODS: We retrospectively studied 39 patients with West syndrome who accepted KD therapy from May 2011 to October 2017. Outcomes including clinical efficacy and EEG features with hypsarrhythmia severity scores were analyzed. RESULTS: After 3 months of treatment, 20 patients (51.3%) had ≥50% seizure reduction, including 4 patients (10.3%) who became seizure-free. After 6 months of treatment, 4 patients remained seizure free, 12 (30.8%) had 90-99% seizure reduction, 8 (20.5%) had a reduction of 50-89%, and 15 (38.5%) had <50% reduction. Hypsarrhythmia scores were significantly decreased at 3 months of KD. They were associated with seizure outcomes at 6 months independent of gender, the course of disease and etiologies. Patients with a hypsarrhythmia score ≥8 at 3 months of therapy may not be benefited from KD. CONCLUSION: Our findings suggest a potential benefit of KD for patients with drug-resistant West syndrome. Early change of EEG after KD may be a predictor of a patient's response to the therapy.
OBJECTIVE: The aim of this study was to evaluate the clinical efficacy and electroencephalographic (EEG) changes of West syndrome after ketogenic diet (KD) therapy and to explore the correlation of EEG features and clinical efficacy. PATIENTS AND METHODS: We retrospectively studied 39 patients with West syndrome who accepted KD therapy from May 2011 to October 2017. Outcomes including clinical efficacy and EEG features with hypsarrhythmia severity scores were analyzed. RESULTS: After 3 months of treatment, 20 patients (51.3%) had ≥50% seizure reduction, including 4 patients (10.3%) who became seizure-free. After 6 months of treatment, 4 patients remained seizure free, 12 (30.8%) had 90-99% seizure reduction, 8 (20.5%) had a reduction of 50-89%, and 15 (38.5%) had <50% reduction. Hypsarrhythmia scores were significantly decreased at 3 months of KD. They were associated with seizure outcomes at 6 months independent of gender, the course of disease and etiologies. Patients with a hypsarrhythmia score ≥8 at 3 months of therapy may not be benefited from KD. CONCLUSION: Our findings suggest a potential benefit of KD for patients with drug-resistant West syndrome. Early change of EEG after KD may be a predictor of a patient's response to the therapy.