What is your experience with the ketogenic diet (or other dietary treatments), VNS, DBS or "other" treatments (complementary/alternative treatments that your patients might have used) ?
I have seen a patient with JME/JAE spectrum, with mix of absence & myoclonic seizures, who did quite well with KD. Seizure frequency has been less by more than 70% over 1st 6 months of KD. I also know another patient with myoclonic/astatic underwent d-econnecting epilepsy surgery with significant improvement.
If you consider the 5 major progressive myoclonic epilpesies including: Unverricht-Lundborg disease, myoclonic epilepsy with ragged red fibers (MERRF), Lafora disease, the neuronal ceroid lipofuscinoses, and sialidoses, then I would say that neither KD nor VNS were efficient in significantly controlling the seizures apart from some amelioration which is variable in duration of response.
Other syndromes including myoclonic seizures e.g. Dravet or Doose: the ketogenic diet is superior to VNS . Sometimes the combination of the 2 is beneficial.
Dr. Mahmoud: Yes, I meant the major progressive myoclonic epilepsies. I would be interested to hear how many patients you and your colleagues have treated with KD or VNS.?
VNS did not touch 3 patients with PME and in other epileptic encephalopathies was ameliorating more than curative.
KD improved 1 patient with NCL for 6 months, but seizures recurred again to the same level previously reported. I did not try KD in Lafora as that was studied 15-16 years ago in US without significant feedbacks. Other conditions of PME included 1 patient for different conditions without success, while my patients with other epileptic syndromes including LGS showed very good responses.