Early- and late-onset complications of the ketogenic diet for intractable epilepsy

hoonchul kang, Da Eun Chung, Dong Wook Kim, HeungDong Kim

Research output: Contribution to journalArticle

193 Citations (Scopus)

Abstract

Purpose: This study was undertaken to evaluate the exact limitations of the ketogenic diet (KD) and to collect data on the prevention and management of its risks. Methods: Patients (129) who were on the KD from July 1995 to October 2001 at our epilepsy center were assessed in the study. Early-onset (within 4 weeks of the commencement of the KD until stabilization) and late-onset complications (occurring after 4 weeks) were reviewed. Results: The most common early-onset complication was dehydration, especially in patients who started the KD with initial fasting. Gastrointestinal (GI) disturbances, such as nausea/vomiting, diarrhea, and constipation, also were frequently noted, sometimes associated with gastritis and fat intolerance. Other early-onset complications, in order of frequency, were hypertriglyceridemia, transient hyperuricemia, hypercholesterolemia, various infectious diseases, symptomatic hypoglycemia, hypoproteinemia, hypomagnesemia, repetitive hyponatremia, low concentrations of high-density lipoprotein, lipoid pneumonia due to aspiration, hepatitis, acute pancreatitis, and persistent metabolic acidosis. Late-onset complications also included osteopenia, renal stones, cardiomyopathy, secondary hypocarnitinemia, and iron-deficiency anemia. Most early- and late-onset complications were transient and successfully managed by careful follow-up and conservative strategies. However, 22 (17.1%) patients ceased the KD because of various kinds of serious complications, and four (3.1%) patients died during the KD, two of sepsis, one of cardiomyopathy, and one of lipoid pneumonia. Conclusions: Most complications of the KD are transient and can be managed easily with various conservative treatments. However, life-threatening complications should be monitored closely during follow-up.

Original languageEnglish
Pages (from-to)1116-1123
Number of pages8
JournalEpilepsia
Volume45
Issue number9
DOIs
Publication statusPublished - 2004 Sep 1

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Ketogenic Diet
Cardiomyopathies
Pneumonia
Hypoproteinemia
Hyperuricemia
Iron-Deficiency Anemias
Hyponatremia
Metabolic Bone Diseases
Hypertriglyceridemia
Risk Management
Gastritis
Constipation
HDL Lipoproteins
Acidosis
Drug Resistant Epilepsy
Hypercholesterolemia
Dehydration
Hypoglycemia
Pancreatitis
Nausea

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

kang, hoonchul ; Chung, Da Eun ; Kim, Dong Wook ; Kim, HeungDong. / Early- and late-onset complications of the ketogenic diet for intractable epilepsy. In: Epilepsia. 2004 ; Vol. 45, No. 9. pp. 1116-1123.
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abstract = "Purpose: This study was undertaken to evaluate the exact limitations of the ketogenic diet (KD) and to collect data on the prevention and management of its risks. Methods: Patients (129) who were on the KD from July 1995 to October 2001 at our epilepsy center were assessed in the study. Early-onset (within 4 weeks of the commencement of the KD until stabilization) and late-onset complications (occurring after 4 weeks) were reviewed. Results: The most common early-onset complication was dehydration, especially in patients who started the KD with initial fasting. Gastrointestinal (GI) disturbances, such as nausea/vomiting, diarrhea, and constipation, also were frequently noted, sometimes associated with gastritis and fat intolerance. Other early-onset complications, in order of frequency, were hypertriglyceridemia, transient hyperuricemia, hypercholesterolemia, various infectious diseases, symptomatic hypoglycemia, hypoproteinemia, hypomagnesemia, repetitive hyponatremia, low concentrations of high-density lipoprotein, lipoid pneumonia due to aspiration, hepatitis, acute pancreatitis, and persistent metabolic acidosis. Late-onset complications also included osteopenia, renal stones, cardiomyopathy, secondary hypocarnitinemia, and iron-deficiency anemia. Most early- and late-onset complications were transient and successfully managed by careful follow-up and conservative strategies. However, 22 (17.1{\%}) patients ceased the KD because of various kinds of serious complications, and four (3.1{\%}) patients died during the KD, two of sepsis, one of cardiomyopathy, and one of lipoid pneumonia. Conclusions: Most complications of the KD are transient and can be managed easily with various conservative treatments. However, life-threatening complications should be monitored closely during follow-up.",
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Early- and late-onset complications of the ketogenic diet for intractable epilepsy. / kang, hoonchul; Chung, Da Eun; Kim, Dong Wook; Kim, HeungDong.

In: Epilepsia, Vol. 45, No. 9, 01.09.2004, p. 1116-1123.

Research output: Contribution to journalArticle

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N2 - Purpose: This study was undertaken to evaluate the exact limitations of the ketogenic diet (KD) and to collect data on the prevention and management of its risks. Methods: Patients (129) who were on the KD from July 1995 to October 2001 at our epilepsy center were assessed in the study. Early-onset (within 4 weeks of the commencement of the KD until stabilization) and late-onset complications (occurring after 4 weeks) were reviewed. Results: The most common early-onset complication was dehydration, especially in patients who started the KD with initial fasting. Gastrointestinal (GI) disturbances, such as nausea/vomiting, diarrhea, and constipation, also were frequently noted, sometimes associated with gastritis and fat intolerance. Other early-onset complications, in order of frequency, were hypertriglyceridemia, transient hyperuricemia, hypercholesterolemia, various infectious diseases, symptomatic hypoglycemia, hypoproteinemia, hypomagnesemia, repetitive hyponatremia, low concentrations of high-density lipoprotein, lipoid pneumonia due to aspiration, hepatitis, acute pancreatitis, and persistent metabolic acidosis. Late-onset complications also included osteopenia, renal stones, cardiomyopathy, secondary hypocarnitinemia, and iron-deficiency anemia. Most early- and late-onset complications were transient and successfully managed by careful follow-up and conservative strategies. However, 22 (17.1%) patients ceased the KD because of various kinds of serious complications, and four (3.1%) patients died during the KD, two of sepsis, one of cardiomyopathy, and one of lipoid pneumonia. Conclusions: Most complications of the KD are transient and can be managed easily with various conservative treatments. However, life-threatening complications should be monitored closely during follow-up.

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