Traditionally used for intractable childhood epilepsy, the high fat, low carbohydrate ketogenic diet was found by a study to be an effective first-line treatment for spasms among four to eight-month old infants with epilepsy.

The study, led by Dr. Eric Kossoff, a pediatric neurologist at Johns Hopkins Hospital, compared the use of the ketogenic diet for treatment before medications are administered and the use of adrenocorticotropic hormone (ACTH). Though effective in 60 to 70 percent of cases, ACTH is an expensive treatment—costing more than $80,000 for a month’s supply. ACTH treatment is also associated with a 30 to 40 percent recurrence rate of spasms and a string of potentially-serious side effects.

“We knew that the ketogenic diet worked well for difficult-to control infantile spasms, so we thought it would also be effective earlier,” said Dr. Kossoff. In approximately one week from the start of the study, the diet already worked in eight out of 13 infants. Recurring spasms were observed in only one of the infants and was controlled again after adding topiramate to the diet. The diet also presented fewer side-effects than that of the ACTH treatment.

The five infants with which the diet failed to work were given ACTH treatment. The treatment worked quickly in four of the five kids. However, researchers noted that though results were quicker with ACTH, long-term developmental outcomes were the same in the two treatment arms. Accordingly, Johns Hopkins now has the ketogenic diet as one of the typically-offered first-line therapies for new-onset infantile spasms. With this novel use of the ketogenic diet, researchers hope that it may lead to finding another treatment to control new-onset infantile spasms.

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