Quantitative analysis of electroencephalograms performed in a patient submitted to ketogenic diet. Are there changes in brain electrical activity in state of ketosis?

*Correspondence: [e-mail].

Abstract

Background: The ketogenic diet is a medical treatment indicated for the control of epileptic seizures in patients diagnosed with Drug-Resistant Epilepsy. Several cohort series have reported the effectiveness of the diet. In a bibliographic review in PUBMED on electroencephalographic analysis as proof of the anti-crisis effect of the ketogenic diet, it was observed that, in most studies, visual counts were performed without systematic quantitative analysis using certified mathematical programs.

Objective: To prospectively and quantitatively investigate brain electrophysiological transformations of a patient with Drug-Resistant Epilepsy and treated with ketogenic diet, through specific mathematical/computational programs aimed at quantitative analysis of electroencephalograms performed.

Methods: A prospective, comparative and quantitative longitudinal analysis (December 10, 2021 to March 31, 2022) was carried out, in which 3 electroencephalograms were performed in a female patient, at 3 years of age, with diagnosis of Drug-Resistant Epilepsy due to Neonatal Ischemic Hypoxic Encephalopathy, with indication of ketogenic diet. They were performed according to homogeneous protocols. The patient had her blood ketosis levels measured daily.

Results: Statistical significance was observed in the reduction in the frequency of epileptic seizures as ketosis levels were established, as well as in the reduction in the overall frequency of reported epileptic seizures, reduction in the DELTA band and increase in the THETA and ALPHA bands in the frontal regions associated with increased entropy in the same territory, with no changes to the visual inspection of the electroencephalogams.

Conclusion: These findings imply that these physiological changes are related to the reduction of reported epileptic seizures, even though there are no visual changes to electroencephalogam tracings. Thus, the visual evolution of the electroencephalogam may not be a parameter for definition of response to the ketogenic diet.

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Artikel online veröffentlicht:
12. Mai 2025