Objective To investigate the efficacy of lacosamide combined with ketogenic diet in the treatment of pediatric epilepsy and its impacts on the levels of serum glial fibrillary acidic protein (GFAP) and specific protein of the central nervous system (S-100β).

Methods A total of 64 children with epilepsy from July 2022 to April 2024 were selected and randomly divided into conventional group (n=32) receiving oral lacosamide tablets and combined group (n=32) receiving ketogenic diet therapy based on the conventional group. The efficacy, cognitive function, and intelligence of children in both groups after treatment, as well as the levels of serum GFAP and S-100β, the frequency of seizures, and electroencephalogram (EEG) findings before and after treatment were evaluated.

Results After treatment, the number of alpha waves, the Full-scale Intelligence Quotient (FIQ) of the Wechsler Intelligence Scale for Children, and the Montreal Cognitive Assessment (MoCA) scores increased in both groups, with a greater increase in the combined group compared to the conventional group, and the differences were statistically significant (P < 0.05). The levels of serum S-100β and GFAP, the frequency of seizures, and the number of cases with slow waves and epileptiform waves decreased after treatmen, and these indicators were lower in the combined group than in the conventional group, with statistically significant differences (P < 0.05). The total effective rate was 90.63% in the combined group and 68.75% in the conventional group, with a statistically significant difference (P < 0.05). The incidence of adverse reactions was 12.50% in the combined group and 9.38% in the conventional group, with no statistically significant difference (P>0.05).

Conclusion Lacosamide combined with ketogenic diet shows good efficacy in the treatment of pediatric epilepsy, and the combined therapy improves neurological function by synergistically reducing the levels of GFAP/S-100β.