Scientists looked at 22 studies involving over 1,000 children with a severe type of seizure called epileptic spasms. They found that a special high-fat, low-carb diet called the ketogenic diet helped about half of these kids have 50% fewer seizures within 3 months. About 1 in 4 children became completely seizure-free. This diet works by changing how the brain uses energy, which can reduce seizure activity. While the results are promising, doctors still need to figure out which children are most likely to benefit from this treatment approach.

The Quick Take

  • What they studied: How well a special high-fat diet works for children with severe seizures called epileptic spasms
  • Who participated: 1,077 children from 22 different studies, mostly boys (62%), with an average age of 16 months when they started the diet
  • Key finding: 48% of children had their seizures cut in half within 3 months, and 25% became completely seizure-free
  • What it means for you: If your child has epileptic spasms, this diet might help, but work closely with doctors since it requires careful monitoring and isn’t right for everyone

The Research Details

This was a meta-analysis, which means researchers gathered data from 22 separate studies that had already been done. They combined all the results to get a bigger picture of how well the ketogenic diet works for children with epileptic spasms. The researchers followed strict guidelines to make sure they included only high-quality studies and analyzed the data properly. Most children in these studies followed the classic ketogenic diet, which is very high in fat and extremely low in carbs, while about 10% tried a modified version called the Atkins diet.

By combining many smaller studies, researchers can get more reliable results than any single study could provide. This approach helps doctors make better treatment decisions because it’s based on experiences from over 1,000 children rather than just a few dozen.

The researchers used established guidelines for reviewing studies and included children from different countries and medical centers. However, they couldn’t identify which children were most likely to benefit, which means more research is still needed.

What the Results Show

After 3 months on the ketogenic diet, nearly half of the children (48%) experienced a significant reduction in their seizures, with spasms decreasing by 50-99%. One in four children (25%) became completely free of spasms. The results were fairly consistent at 6 months, with 41% still having major seizure reduction and 25% remaining seizure-free. Most children followed the classic ketogenic diet, which requires eating about 90% of calories from fat and very few carbs. The diet appeared to work regardless of what caused the child’s epilepsy, whether it was due to brain structure problems, genetic issues, or unknown causes.

The study found that about two-thirds of children had a known cause for their epilepsy, with brain structure problems being the most common reason. Boys were more likely to have epileptic spasms than girls. The average age when children started the diet was 16 months, though some started as early as 8 months and others as late as 23 months.

These results are consistent with other research showing that the ketogenic diet can be helpful for hard-to-treat epilepsy. The seizure-free rates are similar to what doctors have seen in clinical practice, giving more confidence that this treatment approach can work for many children with epileptic spasms.

The researchers couldn’t figure out which children were most likely to benefit from the diet, making it hard to predict who should try it. The studies didn’t follow children for very long periods, so we don’t know about long-term effects. Also, the diet can be challenging to follow and may have side effects that weren’t fully captured in this analysis.

The Bottom Line

The ketogenic diet appears to be a reasonable treatment option for children with epileptic spasms, especially when other treatments haven’t worked well. However, this diet requires close medical supervision and should only be started with a specialized epilepsy team that includes doctors and nutritionists.

Parents of children with epileptic spasms should discuss this option with their child’s neurologist. The diet isn’t appropriate for all children and requires significant lifestyle changes for the whole family. Children with certain metabolic conditions may not be able to safely follow this diet.

If the diet is going to help, improvements typically become noticeable within 3 months. Some children may see benefits sooner, but it’s important to give the diet enough time to work while monitoring for any problems.

Want to Apply This Research?

  • Track daily seizure frequency, duration, and intensity, along with ketone levels if recommended by your doctor
  • Work with a nutritionist to plan and track high-fat, low-carb meals that meet the strict requirements of the ketogenic diet
  • Monitor seizure patterns, medication changes, and any side effects over 6-12 months to evaluate the diet’s effectiveness

This information is for educational purposes only and should not replace professional medical advice. The ketogenic diet for epilepsy requires strict medical supervision and should only be started under the guidance of a qualified epilepsy specialist and registered dietitian.