The prognosis of specific

epilepsies treated with KD depends on the type. For example, the outcome at 3 months after initiation of the KD in patients with intractable childhood epilepsy as a result of focal malformation of cortical development was that 61.7% showed a >50% reduction in seizure frequency, including 44.7% who became seizure-free. Of the 21 patients with complete seizure control at 3 months, 76.2% had successfully completed the diet for 2 years without Inhibitors,research,lifescience,medical relapse, and 47.6% remained seizure-free after cessation of the diet (mean follow-up 3 years and 10 months), including 1 patient who remained seizure-free with additional medication after a relapse.30 A Epacadostat in vivo second example is Dravet syndrome: of the 24 patients who were placed on the KD and followed-up for a minimum

of Inhibitors,research,lifescience,medical 2 years, 66.6% remained on the diet and 12.5% became seizure free, 62.5% had a 75%–99% decrease in the number of seizures, and the remaining 25% had a 50%–74% decrease in the number of seizures.31 Considering the severity and refractivity of seizures in patients with Dravet syndrome, the fact that 12 of 16 children who remained on the diet had a significant reduction in the number of seizures indicates that the KD is currently an interesting therapeutic option.31 A third example is IS. Hong et al.25 Inhibitors,research,lifescience,medical reported 104 infants among whom a spasm improvement Inhibitors,research,lifescience,medical of >50% was seen in 64% at 6 months and 77% after 1–2 years, while 37% became spasm-free for at least 6 months (a median of 2.4 months since starting the KD). In addition, 62% showed improvement in development, 35% had improvement on their EEGs, and 29% were able to reduce the number of concurrent anticonvulsants. Adverse effects were noted in 33%, of which 6% had diminished linear growth. Older age at onset of IS and fewer prior anticonvulsants were considered as being more likely to be associated Inhibitors,research,lifescience,medical with a >90% spasm improvement at 6 months. The authors concluded that the KD is an efficacious

therapy for IS in approximately two-thirds of treated patients and that it should be strongly considered after failure of corticosteroids and vigabatrin.25 MODIFICATION OF THE KD A growing body of evidence demonstrated that dietary therapies for epilepsy, Casein kinase 1 including new modifications (classic KD, medium-chain triglyceride diet, modified Atkins diet, and low-glycemic-index treatment) are highly effective, with approximately 30%–60% of children having at least a 50% reduction in the number of seizures after 6 months of treatment.32 During a fasting state, the body passes through various phases of hormonal and metabolic adaptation in an attempt to spare protein breakdown and to draw on the energy reserves of body fat. The muscles and other tissues progressively switch their energy source from glucose to free fatty acids.