The proportion of drug-resistant (DR) patients among patients with epilepsy is about 30%. Incurable epilepsy causes irreparable damage to the health of patients, especially in childhood, causing so-called epileptic encephalopathy, leading to regression of cognitive and motor functions. The use of a ketogenic diet (KD) - opens up great therapeutic possibilities, often leading to complete relief of epileptic seizures. 

The aim of the study is to analyze the effectiveness of KD in children with drugresistant epilepsy (DRE), changes in psychomotor functions against the background of diet therapy (to conduct a comprehensive, not only qualitative, but also quantitative assessment of the evolution of psychomotor functions of patients using the EpiTrack test, as well as to analyze the effectiveness of KD in relation to various types of epileptic seizures, using the Hague scale. 

600 patients aged 4 months to 18 years receiving KD are under observation. Among them, 45 patients had glucose transporter deficiency syndrome type 1 (GLUT1). 

The effectiveness of KD in relation to epileptic seizures (n = 600): < 50% - 96 children (16%), > 50% - 84 children (14%), > 75% - 126 children (21%), 100% - 114 people (19%), no effect - 162 children (27%), side effects - 18 children (3%). 

The effectiveness of KD in GLUT1 syndrome (n=45): < 50% - 4 children (9%), > 50% - 3 children (7%), > 75% - 6 children (13.5%), 100% - 28 people (62%), KD + AED - 100% - 1 person (2%), no effect - 2 children (4.5%), does not receive KD (due to family circumstances) - 1 child (2%). 

An objective assessment of the evolution of seizure severity was carried out using the Hague scale, which includes 13 questions reflecting impaired consciousness during an attack, seizure severity, involuntary urination during an attack, injuries, tongue biting, headache and muscle pain. The following dynamics of the severity of epileptic seizures were noted (n=250): in 36 patients (14%), the severity of seizures decreased from severe to moderate (complex focal seizures evolved into simple focal seizures or the duration of loss of consciousness significantly decreased, the intensity and severity of seizures decreased, urination disappeared, trauma decreased); in 162 patients (65%) - from moderate to mild (significant reduction in the duration of seizures, disappearance of post-seizure disorders, drowsiness and nausea); in 15 patients (6%) the nature of seizures did not change; in 37 patients (15%) there was complete relief of seizures. The EpiTrack Children's Test assesses attention and cognitive functions through verbal and visual-motor mechanisms. This test can be used repeatedly and is suitable for quality control and results of epilepsy therapy. The EpiTrack test includes 6 tasks and takes about 15 minutes to complete. The test can be used for children from 6 to 18 years old. The test is designed to be repeated after 3 months. The tasks include: choice reaction (answer substitution), connect the numbers (visual-motor speed), connect the numbers and dots (mental flexibility), maze (visual-motor predictability), verbal fluency (fast lexical memory), reverse digit span (working memory). 

Results of the EpiTrack test (n=250). >= 36 points (good) were scored by 21 patients (8%), 31 to 35 points (average) were scored by 62 children (25%), 29 to 30 points (moderate impairment) were scored by 88 patients (35%), <= 28 points (significant impairment) were scored by 79 children (32%). While taking KD, there was an improvement in test results in 235 people (94%), no changes in 12 people (5%), and a deterioration in 3 children (1%). 

The total effectiveness of KD intake was 420 people (70%). A clear effectiveness of KD was revealed in genetically determined forms of epilepsy (effect 50-100%) – 82% children. With GLUT1 - KD is a very effective method of pathogenetic therapy, allowing to reduce clinical manifestations: stopping seizures, improving psychomotor development, improving the quality of life of children. The total effectiveness of taking KD with GLUT1 was 42 people (93%). 

No effect: 162 children (27%), with GLUT1 - 2 children (4.5%). 

Improvement of motor and mental functions: noted in 94% of patients. 

KD has a positive effect on motor and mental functions. There is an improvement in self-care skills, hygiene, fine motor skills, a decrease in ataxia, improvement in speech, memory, attention and sociability and, as a result, an improvement in the quality of life, even with a minimal anticonvulsant effect. 

Early diagnosis of cognitive and functional disorders is important, especially at an early age, since in the future they can significantly hinder development, education, professional career, everyday life and social adaptation. 

Favorable conditions for the development of cognitive functions include successful seizure control, early identification of developmental delays, and timely interventions to minimize negative and enhance positive effects of treatment.

TBA