الفهرس 
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Abstract
Epilepsy is one of the most common medical problems that affect infants and children. An estimated 5% of children will have a seizure.
Epilepsy and the conditions that cause epilepsy impact children and their families in many different ways, impacting cognition, behavior,and socioeconomic status. Uncontrolled epilepsy and the condition that cause seizures leave indelible changes that can affect a child for life and even increase the risk of sudden death.
About one-third of epilepsy patients suffer from uncontrolled seizures despite pharmacotherapy.
Refractory epilepsy is associated with increased morbidity and mortality, serious psychosocial consequences, cognitive problems, and reduced quality of life.
Management strategies of refractory epilepsy fall into three main categories: pharmacotherapy, epilepsy surgery, and alternative treatment strategies including neuro stimulation, ketogenic diet, and lifestyle changes.
many studies have found a significantly positive outcome with the use of the KD for treatment of refractory epilepsy in children and adults.
The aim of this study is to evaluate the effect of the KD treatment on quality of life in children with multi drug resistant epilepsy using the Pediatric Quality of Life Inventory ( PedsQL-Epilepsy) questionnaire.
our study is a cross-sectional was conducted at Children’s Mina University Hospital. All children between the ages of 2 and 18 years with refractory epilepsy, and on KD program who attending the neurology and nutritional outpatient clinic between the period from June to December 2021 was included in the study.
Our patients were classified into 4 groups:
group I: Children aged ( 2-4),Group, II: Children aged (5-7),group III: Children aged (8-12),group IV: Children aged (13-18).
The studied groups were subjected to full history taking, General and systemic physical examinations and the Pediatric Quality of Life Inventory (PedsQL-Epilepsy) questionnaire to assess the impact of ketogenic diet on quality of life in multi drug resistant epilepsy.
The majority of participants were from age group( 2-4Y) & (8-12Y), the percent of males 46.7% while females 53.3%, the mean age 6.6 ±3.4 with minimum age of 2 years and maximum of 18 years. mean age 6.6±3.4with a minimum age of 2 years and a maximum of 18 years.
Our results show reported rates of seizure freedom reached 33.3% after six months and reported rates of seizure reduction reached 53% after six months.
The main finding of this study is the improvement in impact on excutive and mood or behavior functions and cognitive scores observed from the third month of the diet onward in patients who were treated with ketogenic diet.
Significant difference before and after use KD in impact on cognitive,excutive and mood or behavior.