Abstract Details

Title Ketogenic Diet and Pediatric Epilepsy – A Historical Review (1920 – 1964)

Topic History of Neurology

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 1-001

Background

Ketogenic diet is an important therapeutic option in intractable pediatric epilepsy.

Objective

The objective of this study was to review existing medical literature from 1920 - 1964 to analyze the historical evidence for the ketogenic diet as a treatment modality for pediatric epilepsy.

Design/Methods Extensive review of published literature from 1920 to 1964.

Results

Based on the biology of starvation in 1921 Wilder at Mayo Clinic described a diet that mimics starvation and causes ketonuria. This diet had a beneficial effect on the control of seizures. Peterman in 1924 observed that of seventeen patients that were administered a ketogenic diet, ten experienced total freedom from attack and of these, nine were treated only with the ketogenic diet. Four showed marked improvement, with three failing to follow up. Hoeffel and Moriarty in 1924 noted an amelioration of epileptic symptoms correlated with decreased blood glucose while fasting in two epileptic children compared to pre-fasting blood glucose levels with a post-fasting decrease in overall incidence of attacks. In 1927 Talbot et al. described a ketogenic diet that is similar to the protocol followed even today.

Helmholtz in 1927 found that twenty-nine of ninety-one patients with idiopathic epilepsy were free of seizures, with twenty more showing significant improvement. Subsequent studies by Lennox (1928) and Helmholz (1930) showed a definite therapeutic effect of ketogenic diet in the management of seizures. McQuarrie and Keith in 1929 Wilkins in 1937 administered a diet with a fat to carbohydrate and protein ratio of 4:1.

Conclusions Ketogenic diet was developed as an epilepsy therapy in early 20th century, an era of limited antiepileptic drug availability. And given the current interest in non-drug treatments of epilepsy a review of the findings of a period when such an interest was a necessity is very valuable.

Authors/Disclosures
Joseph M. Maes PRESENTER	Mr. Maes has nothing to disclose.
Ram Mohan R. Sankaraneni, MD, FANA, FAES, FAAN (Allina Health _ Abott Northwestern Hospital)	Dr. Sankaraneni has nothing to disclose.
Sanjay P. Singh, MD, FAAN (President, Allina Health Neuroscience, Spine & Pain Institute)	Dr. Singh has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for SK LIFE. Dr. Singh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for NEURELIS.