Abstract Details

Title Optimizing Ketogenic Dietary Therapy for Children with Drug-resistant Epilepsy in a Low-income Setting: A Pilot Study on Feasibility and Clinical Outcomes

Topic Child Neurology and Developmental Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 8-001

Objective Evaluate the feasibility and effectiveness of implementing the first Ketogenic Diet Clinic (KDC) in Mexico treating pediatric patients with drug-resistant epilepsy (DRE) in a low-resource setting.

Background

Epilepsy affects 45.9 million people worldwide, and it is estimated that 80% of cases occur in low- and middle-income countries (LMIC) where access to antiseizure medications (ASM) is limited. This has created the need to implement strategies to reduce the treatment gap. The ketogenic diet therapy (KDT) represents an effective option, especially in cases of DRE; however, its use in LMIC has been limited and poorly documented.

Design/Methods A retrospective analysis was conducted on 21 pediatric patients diagnosed with DRE who initiated KDT between July 2022 and July 2024. Data were collected from the institutional database, including seizure control, ASM dose and count reduction, and nutritional interventions. Regular follow-up visits assessed the efficacy of the dietary intervention. Socioeconomic status was also evaluated using a Mexican validated survey. Statistical analysis included descriptive methods to summarize patient characteristics and longitudinal changes.

Results The median time from seizure onset to KDT initiation was 16 months, with the median duration on the diet being 72 weeks. Sixty percent of those attending at least three scheduled visits had a >90% reduction in seizure frequency. Sixty percent experienced a decrease in ASM doses, and 30% reduced their total ASM count. Despite not achieving complete seizure freedom, the KDT provided substantial seizure control and medication reduction.

Conclusions Implementing a well-structured KDC in a low-resource setting is feasible and can significantly benefit pediatric patients with DRE. The KDT led to reduced medication use, lower treatment burden, and improved seizure control in most patients, which supports the expansion of KDT for DRE in areas where access to first-line pharmacological treatments may be limited.

Authors/Disclosures
Paloma Hurtado Cuan PRESENTER	No disclosure on file
MARIA ALEJANDRA SOTO BLANQUEL, RDN	Miss SOTO BLANQUEL has received personal compensation in the range of $0-$499 for serving as a Consultant for STHENDAL. Miss SOTO BLANQUEL has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for STHENDAL. Miss SOTO BLANQUEL has received intellectual property interests from a discovery or technology relating to health care.
Amado Jimenez Ruiz (Hospital Civil de Guadalajara Fray Antonio Alcalde)	Dr. Jimenez Ruiz has nothing to disclose.
Enrique Gomez Figueroa, MD, MSc	Dr. Gomez Figueroa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen Mexico. Dr. Gomez Figueroa has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra Zeneca Mexico. Dr. Gomez Figueroa has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Johnson & Johnson LATAM.
Rosa Marquez, MD	Dr. Marquez has nothing to disclose.
Melissa F. Castillo, Jr., MD	Dr. Castillo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Castillo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB.

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