Objective: To study the clinical efficacy and follow-up study of ketogenic diet adding treatment for refractor epilepsy in children.
Methods: Cluster sampling method was employed to select children in Hunan province children's hospital from January 2015 to June 2017，A total of 25 cases were diagnosed refractor epilepsy and adding ketogenic diet (with the Modified Atkin diet with a lipid-to-nonlipid ratio 1-2:1).Patients were followed up through telephone calls or regular outpatient visits were recommended and recorded the all index. such as blood biochemical, ultrasound screening of urinary system, electroencephalogram and skeletal development. Engel grade was used to evaluate the efficiency at 3 months ,3-6 months ,and more than 6 months, study the side effects , electroencephalogram(EEG) changes and intellectual development.
Results: At 3 months , 3-6 months , and more than 6 months after initiation, 0%, 66.7%，87.5% reduction in their seizure frequency. 33.3%，50%，81.3% reduction in their interictal epileptiform discharges (IED) index. and 33.3%，50%，68.8%  improving intellectual development .Most side effects were mild and reversible by conservative treatment. Gastrointestinal disturbances were the main side effects.
Conclusion: The ketogenic diet is effective, safe, few side effects and tolerable in infants and children with refractory epilepsy，ketogenic diet may improve cognition and behavior in addition to reducing seizure frequency，reduce the IED index and improve the quality of life of epileptic children. However, the current acceptance of ketogenic diets is not enough for parents .