Table 3.

Quality Scores for Included Studies

Study/YearMean AgeSeizure TypeMean Seizure FrequencyMean Number of
Previous AEDs
Developmental Stage/IQInclusion/
Exclusion Criteria
Total
Score
Vining/19984.7 y (range: 1.3–8.6 y; total points = 2)All types except partial seizures alone (total
points = 2)
230/mo (range: 11–1880; total points = 2)7.0 (total points = 2)NR (total points = 0)Inclusion: 1–8 y of age; >10 seizure/wk; at least 2 previous AED trials; electroencephalogram criteria10
Exclusion: partial seizure only; metabolic or degenerative disease; inadequate psychosocial situation (total points = 2)
Freeman, unpublished data5.3 y (range: 4 mo–16 y;
total points = 2)
All types (total points = 2)410/mo (total points = 2)6.2 (total previous AEDs) 1.97 (current AEDs) (total points = 2)70% of patients with IQ <69 (total points = 1)Inclusion: 1–16 y old; >2 seizure/wk; at least 2 previous appropriate AED trials (total points = 1)10
Huttenlocher et al/197110.1 y (range: 2.5–16 y; total points = 2)All types (total points = 2)Range: 1–50 per d in 9/12 patients. Almost continuous in 3/12 (total points = 1)All patients had trials of AEDs in various combinations (total points = 1)NR (total points = 0)Inclusion: at least 4 seizure/wk for a 2-mo period (total points = 1)7
Kinsman et al/19925.5 y (total points = 2)All types (total points = 2)NR (total points = 0)4.9 ± 1.7 (total points = 2)NR (total points = 0)Family and home situation sufficient to adhere to diet (total points = 1)7
Hopkins and Lynch/19706.5 y (range: 1–13 y; total points = 2)Majority of patients had minor motor epilepsy
(total points = 1)
NR (total points = 0)Most had received virtually every anticonvulsant commonly in use (total points = 1)NR (total points = 0)Inclusion: patient had good tolerance of fatty foods; parents and home climate conducive to maintaining diet; able to afford extra cost of diet (total points = 2)6
Trauner/1985Range: 1–13 y (total
points = 1)
All types (total points = 2)13/17 patients had multiple daily seizures; 4/17 had seizures at least every 2–3 wk (total points = 1)All had been tried on numerous anticonvulsant medications (total points = 1)NR (total points = 0)NR (total points = 0)5
Huttenlocher/1976Range 18 mo to 8 y (total points = 1)All types (total points = 2)NR (total points = 0)“Trials on anticonvulsant drugs in various combinations” (total points = 1)NR (total points = 0)NR (total points = 0)4
Janaki et al/197633% 0–10 y 47% 10–20 y 20% 21–30 y (total points = 1)All types (total points = 2)Range 3/wk–29/d (total points = 1)“Recalcitrant seizures despite medication” (total points = 0)NR (total points = 0)NR (total points = 0)4
Berman/1978Range: 2–17 y (total
points = 1)
All types (total points = 2)NR (total points = 0)“Failed to respond to … various drugs or combinations of drugs.” (total points = 1)NR (total points = 0)NR (total points = 0)4
Sills et al/1986NR (total points = 0)Generalized tonic-clonic, myoclonic absence, or complex partial (total points = 2)NR (total points = 0)“Failed to respond to appropriate anticonvulsant given as a single agent” (total points = 1)NR (total points = 0)Inclusion: children considered to have a good chance of achieving reasonable function (total points = 1)4
Schwartz et al/198934% 0–5 y 42% 5–10 y 15% 10–15 y 9% >15 y (total points = 1)All types (total points = 2)NR (total points = 0)“… failed to respond to adequate trials of conventional anti-epileptic therapy” (total points = 1)NR (total points = 0)NR (total points = 0)4
Historical controls (Huttenlocher and
Haphel/1990)
3.4 y old (age at onset)All typesMore than 1 seizure/moUncontrolled seizure “despite … appropriate anticonvulsant agents at maximum tolerated blood levels”61% of patients with mild/moderate mental retardation (IQ <70)Age of onset <13 y; IQ >30; absence of cerebral mass lesion; presence of epileptiform discharges on electroencephalogram
  • NR indicates no report.

    Scoring key: 0 = no information on this parameter contained in report; 1 = some information contained in report, but of vague nature, or incompletely reported (eg, frequent seizures; previous use of multiple AEDs); and 2 = contained explicit information on parameter in report (eg, all patients had seizure frequency of greater than 1 week; patients had failed at least 2 trials of AEDs).