Evidence map›Paper›PMID 32173786›Full record

SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2020

Ketogenic diet for the treatment of pediatric epilepsy: review and meta-analysis.

Jo Sourbron, Sylvia Klinkenberg, Sander M J van Kuijk, Lieven Lagae, Danielle Lambrechts, Hilde M H Braakman, Marian Majoie

Abstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 9 pooled it
7.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

49 citing papers in PubMed, 9 syntheses or guidelines pooled it, 106 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Jo SourbronDepartment of Development and Regeneration, Section Pediatric Neurology, University Hospital KU Leuven, Herestraat 49, box 7003 20, 3000, Leuven, Belgium. j.sourbron@gmail.com.ORCID 0000-0002-5319-6495
Sylvia KlinkenbergKempenhaeghe Centre for Neurological Learning Disabilities, Heeze, the Netherlands.
Sander M J van KuijkDepartment of Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University, Maastricht, the Netherlands.
Lieven LagaeDepartment of Development and Regeneration, Section Pediatric Neurology, University Hospital KU Leuven, Herestraat 49, box 7003 20, 3000, Leuven, Belgium.
Danielle LambrechtsDepartment of Neurology, Academic Center for Epileptology, Kempenhaeghe & Maastricht UMC+, Heeze, Netherlands.
Hilde M H BraakmanDepartment of Pediatric Neurology, Amalia Children's Hospital, Radboud University Medical Center & Donders Institute for Brain, Cognition and Behavior, Nijmegen, Netherlands.
Marian MajoieDepartment of Neurology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands.
Maastricht University Medical Centre · NLKU Leuven · BEMaastricht University · NLRadboud University Nijmegen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The ketogenic diet (KD), containing high levels of fat and low levels of carbohydrates, has been used to treat refractory epilepsy since the 1920s. In the past few decades, there has been more interest in less restrictive KDs such as the modified Atkins diet (MAD). PURPOSE: Our aim was to review all evidence regarding the efficacy and tolerability of the KD and MAD from randomized controlled trials (RCTs) in children and adolescents with refractory epilepsy.

methodsWe reviewed the current literature using Cochrane, EMBASE, and MEDLINE (using PubMed). We implemented predefined criteria regarding dataextraction and study quality.

resultsWe identified five RCTs that generated seven publications and recruited 472 children and adolescents with refractory epilepsy (≤ 18 years). The primary outcome (seizure frequency reduction (SFR) ≥ 50%) was attained in 35-56.1% of the participants in the intervention group, compared with 6-18.2% in the control group. Our meta-analysis underlined the significant efficacy of the KD compared with the control group: RR = 5.1 (95% CI 3.18-8.21, p < 0.001). Additionally, only two studies mentioned possible biomarkers to objectively evaluate the efficacy. Secondary outcomes, such as seizure severity and quality of life, were studied in three trials, leading to indecisive generalization of these findings. Gastro-intestinal adverse effects were the most prevalent, and no severe adverse effects were reported.

conclusionDespite the heterogeneity between all studies, the beneficial results underline that dietary interventions should be considered for children and adolescents with refractory epilepsy who are not eligible for epilepsy surgery. Future studies should be multi-center and long-term, and evaluate potential biomarkers and adverse effects.

Indexed as

Diet, KetogenicDrug Resistant EpilepsyEpilepsyAdolescentChildHumansSeizuresTreatment OutcomeDrug-resistantEpilepsyKetogenic dietMeta-analysisModified Atkins diet

Identifiers

PMID32173786
OpenAlexW3011063246

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.