Clinical effectiveness of ketogenic diet supplemented with powdered formula as an adjuvant in children with refractory epilepsy: a real-world study
DOI:
https://doi.org/10.14306/renhyd.29.3.2343Keywords:
Drug Resistant Epilepsy, Ketogenic Diet, Nutritional Support, Treatment Outcome, PediatricsAbstract
Introduction: Refractory epilepsy in childhood poses a significant therapeutic challenge, with high clinical and social burden. Ketogenic dietary therapy (KDT), including 4:1 ketogenic powder formula, has shown efficacy as adjunctive treatment.
Objective: To evaluate the effectiveness, safety, and tolerability of KDT supplemented with powdered ketogenic formula (KetoCal® 4:1) over 12 months in children with refractory epilepsy at a specialized center in Colombia.
Methods: Retrospective cohort observational study. Twenty-five pediatric patients with refractory epilepsy receiving KDT were included. The main outcome was the change in monthly seizure frequency. Secondary outcomes included hospitalizations, antiepileptic drug adjustments, nutritional status evolution, and adverse events. Statistical analysis included Wilcoxon tests, linear mixed-effects models, and Spearman correlation.
Results: The median number of monthly seizures decreased from 60 to 1 at 12 months (p = 0.001). An excellent response (≥90% reduction in seizure frequency) was achieved in 60% of patients, and 44% achieved complete seizure control. Hospitalizations decreased from 36% to 16%, and 40% of patients reduced their antiepileptic drug burden. Nutritional status improved in 50% of initially malnourished patients. Mild adverse events occurred in 56% of cases, mostly gastrointestinal, with no treatment discontinuations. A higher baseline seizure frequency was significantly associated with a better response (p = 0.01).
Conclusions: KDT supplemented with a specialized ketogenic formula achieved sustained seizure reduction and was well tolerated among patients completing follow-up. Additional benefits included fewer hospitalizations, reduced pharmacological load, and improved nutritional status. This strategy is feasible in low-resource settings, provided structured, multidisciplinary follow-up is ensured.
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