The use of K.Vita in a teenager with drug-resistant epilepsy | Case study

The case study discusses a 15-year-old girl with drug-resistant epilepsy who had excellent adherence to K.Vita, resulting in improved seizure control and quality of life.

Patient details and medical history

Age: 15 years.

Gender: Female.

Diagnosis and relevant medical history

• Onset of epilepsy in infancy.
• Meningoencephalitis at 1 year of age with subsequent left-sided brain abnormalities.
• Mild right-sided hemiparesis.
• ADHD.

History before starting K.Vita

• Focal and general tonic clonic seizures.
• Two general tonic clonic seizures per week and 40-50 focal seizures daily.
• Evaluated as unsuitable for epilepsy surgery.

Medication

Methylphenidate, Melatonin, Lamotrigine, Levetiracetam.

Dietetic Management

Feeding route

Oral.

Previous use of the ketogenic diet

At 14 years of age, she was fully adherent to the medium chain triglyceride ketogenic diet for 3.5 weeks, however, her seizure burden increased significantly so she was weaned off the diet over 3 days. Following its discontinuation, her seizure burden remained high and began to worsen, impacting her quality of life and attendance and learning ability at school.

Dietary Management with K.Vita

• Introduce K.Vita incrementally by following the Vitaflo 4-week introduction plan for children, aiming for a target daily amount of 120ml (4 x 30ml).
• Always take K.Vita with some food.
• To follow her usual diet but avoid foods and beverages high in sugar.

Acceptability and tolerability of K.Vita

At the end of the four-week introduction, the frequency and amount of K.Vita was changed to 3 x 40ml daily as she was struggling with the texture of the product and finding it difficult to take the fourth portion at bedtime.

After 3 months, her family was advised to freeze K.Vita to make ice-pops, mix it into yoghurt or fruit, or to use it in permitted recipes to try and improve its palatability for her.  Despite struggling with nausea, she has continued to take 120ml of K.Vita daily and follow the dietary advice given.

Anthropometry

No growth concerns since starting K.Vita.  

Outcomes

Within two weeks of introducing K.Vita her seizure frequency had reduced and on reaching her target amount after four weeks she became seizure-free, apart from a few focal seizures. Her medication remained the same.

After the introduction, she continued to take 3 x 40 ml (120ml) K.Vita daily.  At six months her improvement in seizure frequency had been maintained. She reported no further tonic-clonic seizures and only 2 prolonged focal seizures in the previous 2 months.

Conclusions and key learnings

• K.Vita provided this 15-year-old girl with a background of meningoencephalitis and drug-resistant epilepsy an alternative, effective and much less restrictive dietary management option to the ketogenic diet.  
• Despite difficulties with accepting and tolerating the taste and texture of K.Vita, her adherence is excellent, and she has had significant reduction in seizures.
• She can now attend school regularly and holiday abroad with her family, and she continues to take K.Vita.