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Open AccessArticle

Electrographic Changes Accompanying Recurrent Seizures under Ketogenic Diet Treatment

1
Laboratory of Experimental Epileptology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
2
Pediatric Neurology, Polyclinic Hospital, 41124 Modena, Italy
3
Azienda Unità Sanitaria Locale di Modena, 41121 Modena, Italy
4
Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41125 Modena, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Pharmaceuticals 2017, 10(4), 82; https://doi.org/10.3390/ph10040082
Received: 26 September 2017 / Revised: 17 October 2017 / Accepted: 19 October 2017 / Published: 20 October 2017
(This article belongs to the Special Issue Epilepsy and Neurodegeneration: Current Therapeutic Implications)
The ketogenic diet (KD) is increasingly used to treat epilepsy refractory to antiepileptic drugs and other neurological disorders. In animal models, the KD was found to increase the threshold to seizures induced by different convulsive stimulations. However, in models in which suprathreshold stimuli were used, a paradoxical seizure worsening was consistently observed in KD-fed animals. To better define this phenomenon, we characterized the electrographic response to seizures induced in mice which were treated with the KD, and then corneally stimulated at 6-Hz in four different sessions. We also evaluated the electroencephalogram (EEG) in three patients in which the KD was associated with a paradoxical worsening of epileptic seizures. Although seizures were initially less severe, a remarkable prolongation of the electrographic response was observed in mice receiving the KD from the second session of 6-Hz corneal stimulation and onwards. The EEG was also markedly altered in the presence of progressive seizure aggravation observed in children treated with the KD, specifically one affected by Lennox–Gastaut syndrome and two by type I lissencephaly. These results suggest that when seizures are induced or recur because of resistance to therapeutic interventions, the KD may change the EEG by potentiating the electrographic epileptic activity. View Full-Text
Keywords: 6-Hz corneal stimulation; electroencephalography; ketogenic diet; Lennox-Gastaut syndrome; lissencephaly; seizure 6-Hz corneal stimulation; electroencephalography; ketogenic diet; Lennox-Gastaut syndrome; lissencephaly; seizure
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Lucchi, C.; Marchiò, M.; Caramaschi, E.; Giordano, C.; Giordano, R.; Guerra, A.; Biagini, G. Electrographic Changes Accompanying Recurrent Seizures under Ketogenic Diet Treatment. Pharmaceuticals 2017, 10, 82.

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