Ketogenic diet in childhood epilepsy: case report and review of literature

Epilepsy/seizure disorder is the most common childhood neurologic condition. Antiepileptic drugs (AEDs) are the mainstay of epilepsy treatment. Ketogenic diet (KD) is an effective dietary therapy for children with intractable epilepsy. However, both these two therapy increase risk of vitamin and mineral deficiency and may cause osteoporosis in children. I report the case of a 7-year-old girl presented with a 2-day history of vomiting and increased seizures activity to three times per week. Her past medical history is remarkable for epilepsy and has been on multiple AEDs since age 16 month. The 3:1 ratio KD was started from age 3 with a moderate improvement in seizure activity from weekly episode to monthly. To enhance the effect of ketosis on seizure control, she was put on 4:1 ration KD with gradual improvement. Bone density scan (DEXA scan) shows worsening bone mineral density through the past year possibly due to immobility and long term AEDs and KD uses. Calcium and vitamin D supplement together with adequate energy intake is important to manage her osteoporosis and promote optimal growth.Master of Public Healt