We report the efficacy of the  Mediterranean Style Ketogenic diet(KD) in refractory epilepsies focusing on outcomes with regard to epilepsy syndromes and etiology in children with refractory epilepsy. 76 consecutive children  were retrospectively enrolled from 2012 to 2013

Method:

The Mediterranean Style Ketogenic diet was initiated on an outpatient basis with dietary ratios ranging from 2:1 to 4:1 fat to carbohydrate and protein.The hospital records of the patients given KD due to resistant epilepsy in the pediatric neurology department of our hospital between June 2012 and March 2013 were examined retrospectively.

All datas recorded as age, sex, diagnosis, seizure type, epilepsy syndrome, associated otism physical activity, number of antiepileptic drugs(AED), previous ACTH treatment,  period of KD therapy, KD rate applied, Ig G, Ig A, Ig M ,Selenium,Carnitine, fT3,fT4,TSH,  Total cholesterol, Total cholesterol levels at least 1 week before KD and 1, 3,6,9,12 months after the therapy started. Moreover, in order to determine the side effects of the treatment. We follow up the   efficacy of the diet with blood ketone levels.

Results: At the first month of KD %38.4 of patients seizure free and %38.4 0f patients have %50-99 seizure reduction. Blood ketone level at which patients became seizure-free was found mean 4.45±0.70

We found immobility (p<0.001) , previous ACTH treatment (p<0.001) , constipation (p<0.001) have negative effect on ketogenic diet.

Side effects (constipation%12.5, Hyperlipidemia %35,renal stones %0) were found lower than literature.

Conclution: Mediterranean Style KD could be a new challenge more than classical KD