الفهرس 
DRUG RESISTANT EPILEPSYOnly 14 pages are availabe for public view
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Abstract
The ketogenic diet continues to be one of the most effective therapies for drug-resistant epilepsy in the pediatric population. The restricted food choices of a ketogenic diet raise concerns about possible deficiencies in vitamin and mineral intake. Our aim was to detect symptoms and signs of vitamin E deficiency and measuring its serum level in a cohort of patients with drug resistant epilepsy before commencing ketogenic diet and 3 months later.
Subjects and Methods:
Twenty patients with drug resistant epilepsy candidates for ketogenic diet were evaluated through the first 3 months of commencing the classic ketogenic diet therapy (4 patients) or MAD (16 patients) tailored according to local Egyptian ingredients.
Dietary assessment was done with calculation of calories utilized per day and amount of vitamin E in patient’s diet. Seizure frequency/day, Chalfont seizure severity scale, weight, length, serum level of vitamin E and lipid profile were assessed upon enrollment and after 3 months.
Results:
Our 20 patients included 10 males and 10 females with mean age of 3.15±2.92 years. The etiology of epilepsy was: Structural/Metabolic(10); Malformation of cortical development(5), Acquired perinatal insults(5). Genetic (6), Unknown etiology(4). 5o% had GTC, 25% had focal seizures, 15% had infantile spasms and 10% had myoclonic seizures.
Chalfont scores and seizure frequency significantly decreased. The patient’s weight and length z-scores increased non significantly. Serum vitamin E levels decreased significantly. Total cholesterol, triglycerides and LDL serum levels significantly increased.
Conclusion:
KD is an effective therapy for drug resistant epilepsy with improvement in seizure parameters. Serum vitamin E and lipid profile were adversely affected indicating the need for higher doses of vitamin E and longer duration of follow up.