Which dietary modifications are used in the treatment of infantile spasm (West syndrome)?

Updated: Jan 11, 2019
  • Author: Tracy A Glauser, MD; Chief Editor: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP  more...
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Answer

The ketogenic diet has been used successfully to treat a variety of seizure types. Studies have shown that it can be considered for the medical management of infantile spasms. [16]

A 2006 retrospective study showed that the ketogenic diet in a ratio of 4:1 was effective in a small patient population with intractable infantile spasm previously treated with combinations of vigabatrin, topiramate, other AEDs, or prednisolone. A greater than 90% reduction in seizures was seen in 63% of children, and 40% were seizure free at 6 months. Side effects, including gastrointestinal disturbance, infection, and renal stones, were transient. [17]

One center prospectively followed 104 patients with infantile spasms, treated with the ketogenic diet; these patients included both patients with new onset infantile spasms and those that were unsuccessfully treated with other therapies. Of the total patients, 37% became spasm-free for at least 6 months within a median 2.4 months of starting the ketogenic diet, and 64% had a greater than 50% improvement in spasms. [18]


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