Long-term use of the ketogenic diet in drug resistant epilepsy syndromes during childhood: Differences between responders and non-responders in seizure types, EEG, and outcome

2008 ◽  
Vol 39 (05) ◽  
Author(s):  
A Dressler ◽  
E Reithofer ◽  
B Stöcklin ◽  
F Benninger ◽  
M Freilinger ◽  
...  
Keyword(s):  
Ketogenic Diet ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

Long-term effectiveness and adverse effects of ketogenic diet therapy in infants with drug-resistant epilepsy treated at a single center in Argentina

2021 ◽  
pp. 106793
Author(s):  
Marisa Armeno ◽  
Antonella Verini ◽  
Eugenia Caballero ◽  
Araceli Cresta ◽  
Gabriela Reyes Valenzuela ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Ketogenic Diet ◽  
Diet Therapy ◽  
Drug Resistant ◽  
Single Center ◽  
Drug Resistant Epilepsy

scholarly journals D.01 Earlier treatment with the Ketogenic Diet improves seizure outcome in early-onset drug-resistant epilepsy

2016 ◽  
Vol 43 (S2) ◽  
pp. S13-S13
Author(s):  
M Irwin ◽  
S Aimola ◽  
H Lowe ◽  
Y Liu ◽  
M Zak ◽  
...  
Keyword(s):  
Ketogenic Diet ◽  
Early Onset ◽  
Past History ◽  
Seizure Outcome ◽  
Drug Resistant ◽  
Treatment Delays ◽  
Young Infants ◽  
History Of ◽  
Drug Resistant Epilepsy

Background: The ketogenic diet (KD) is used to treat severe childhood-onset epileptic encephalopathies, such as Infantile Spasms (IS). Unfortunately, limited resources for KD initiation result in treatment delays. We ask if earlier KD treatment of early-onset drug-resistant epilepsy results in better seizure outcomes. Methods: Children who started KD before age 4 years between 2000-present at SickKids Hospital were identified. Six-month seizure outcome was calculated as percent of pre-diet baseline seizure frequency (BSF). Results: 67 children were identified. 30 (44.8%) started KD <2 years old, 37 (55.2%) started KD 2-4 years old. Among <2 years old group, 83.3% achieved 50% reduction in BSF and 36.7% achieved 90% reduction. Among 2-4 year old group, 62.2% achieved 50% reduction in BSF and 24.3% achieved 90% reduction. 38 children had a history of IS; 17 with IS at diet initiation and 21 with past history of IS. 41.2% of the spasms cohort achieved 90% reduction in BSF, compared to 23.8% of the post-spasms cohort. Conclusions: KD was more effective when started before age 2 years than 2-4 years, and more effective in children with IS than in children with past history of IS. A rapid protocol for KD initiation in young infants and children may improve long-term outcomes

Vagus nerve stimulation for drug-resistant epilepsy

2019 ◽  
Vol 20 (3) ◽  
pp. 189-198 ◽  
Author(s):  
Laura Pérez-Carbonell ◽  
Howard Faulkner ◽  
Sean Higgins ◽  
Michalis Koutroumanidis ◽  
Guy Leschziner
Keyword(s):  
Vagus Nerve ◽  
Seizure Frequency ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Therapeutic Option ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
Randomised Controlled

Vagus nerve stimulation (VNS) is a neuromodulatory therapeutic option for drug-resistant epilepsy. In randomised controlled trials, VNS implantation has resulted in over 50% reduction in seizure frequency in 26%–40% of patients within 1 year. Long-term uncontrolled studies suggest better responses to VNS over time; however, the assessment of other potential predictive factors has led to contradictory results. Although initially designed for managing focal seizures, its use has been extended to other forms of drug-resistant epilepsy. In this review, we discuss the evidence supporting the use of VNS, its impact on seizure frequency and quality of life, and common adverse effects of this therapy. We also include practical guidance for the approach to and the management of patients with VNS in situ.

scholarly journals Long-Term Effects of a Classic Ketogenic Diet on Ghrelin and Leptin Concentration: A 12-Month Prospective Study in a Cohort of Italian Children and Adults with GLUT1-Deficiency Syndrome and Drug Resistant Epilepsy

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1716 ◽  
Author(s):  
Ramona De Amicis ◽  
Alessandro Leone ◽  
Chiara Lessa ◽  
Andrea Foppiani ◽  
Simone Ravella ◽  
...  
Keyword(s):  
Body Composition ◽  
Nutritional Status ◽  
Body Fat ◽  
Deficiency Syndrome ◽  
Drug Resistant ◽  
Z Score ◽  
Glut1 Deficiency ◽  
Glut1 Deficiency Syndrome ◽  
Drug Resistant Epilepsy

The classical ketogenic diet (cKD) is an isocaloric, high fat, very low-carbohydrate diet that induces ketosis, strongly influencing leptin and ghrelin regulation. However, not enough is known about the impact of a long-term cKD. This study evaluated the effects of a 12-month cKD on ghrelin and leptin concentrations in children, adolescents and adults affected by the GLUT1-Deficiency Syndrome or drug resistant epilepsy (DRE). We also investigated the relationship between the nutritional status, body composition and ghrelin and leptin variations. We carried out a longitudinal study on 30 patients: Twenty-five children and adolescents (15 females, 8 ± 4 years), and five adults (two females, 34 ± 16 years). After 12-monoths cKD, there were no significant changes in ghrelin and leptin, or in the nutritional status, body fat, glucose and lipid profiles. However, a slight height z-score reduction (from −0.603 ± 1.178 to −0.953 ± 1.354, p ≤ 0.001) and a drop in fasting insulin occurred. We found no correlations between ghrelin changes and nutritional status and body composition, whereas leptin changes correlated positively with variations in the weight z-score and body fat (ρ = 0.4534, p = 0.0341; ρ = 0.5901, p = 0.0135; respectively). These results suggest that a long-term cKD does not change ghrelin and leptin concentrations independently of age and neurological condition.

scholarly journals Ketogenic diet in Zambia: Managing drug-resistant epilepsy in a low and middle income country

2020 ◽  
Vol 14 ◽  
pp. 100380
Author(s):  
Kafula Lisa Nkole ◽  
Nfwama Kawatu ◽  
Archana A. Patel ◽  
Chimbizyani Kanyinji ◽  
Theresa Njobvu ◽  
...  
Keyword(s):  
Ketogenic Diet ◽  
Middle Income Country ◽  
Income Country ◽  
Drug Resistant ◽  
Middle Income ◽  
Drug Resistant Epilepsy ◽  
Low And Middle Income

scholarly journals Ketogenic Diet Therapies for Seizures and Status Epilepticus

2020 ◽  
Vol 40 (06) ◽  
pp. 719-729
Author(s):  
Tanya J. W. McDonald ◽  
Mackenzie C. Cervenka
Keyword(s):  
Status Epilepticus ◽  
Ketogenic Diet ◽  
Care Setting ◽  
Drug Resistant ◽  
Anesthetic Agents ◽  
Ketogenic Diets ◽  
Potential Efficacy ◽  
Low Carbohydrate ◽  
History Of ◽  
Drug Resistant Epilepsy

AbstractKetogenic diet therapies are high-fat, low-carbohydrate diets designed to mimic a fasting state. Although initially developed nearly one century ago for seizure management, most clinical trials for the management of drug-resistant epilepsy in children as well as adults have been conducted over the last 3 decades. Moreover, ketogenic diets offer promising new adjunctive strategies in the critical care setting for the resolution of acute status epilepticus when traditional antiseizure drugs and anesthetic agents fail. Here, we review the history of ketogenic diet development, the clinical evidence supporting its use for the treatment of drug-resistant epilepsy in children and adults, and the early evidence supporting ketogenic diet feasibility, safety, and potential efficacy in the management of status epilepticus.

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