Objective: To determine the efficacy, side effects and feasibility of Medium chain triglyceride (MCT) ketogenic diet (KD) in Thai children with intractable epilepsy.
Material and method: Children with intractable epilepsy were recruited. Baseline seizure frequency was recorded over 4 weeks before starting MCT KD. Average seizure frequency was assessed at 1 month and 3 months, compared to the baseline using Wilcoxon Signed Rank Test. Side effects and feasibility were also assessed by blood tests and an interview.
Results: Sixteen subjects were recruited with mean seizure frequency of 0.35-52.5 per day. After treatment, there was a significant reduction in seizure frequency, ranging from 12% to 100% (p = 0.002 at 1 month, and 0.001 at 3 months). 64.3% of the subjects achieved more than 50% seizure reduction at 3 months and 28.6% of the patients were seizure-free. Common adverse effects were initial weight loss (37.5%) and nausea (25%). 87.5% of subjects and parents were satisfied with the MCT KD with 2 cases dropping-out due to diarrhea and non-compliance.
Conclusion: MCT ketogenic diet is effective and feasible in Thai children with intractable epilepsy. Despite modification against Asian culinary culture, the tolerability and maintenance rate was still satisfactory. A larger study is required.