Practical considerations for ketogenic diet in adults with super refractory status epilepticus

2020 ◽  
pp. 10.1212/CPJ.0000000000001009
Author(s):  
Neha Kaul ◽  
Joshua Laing ◽  
John-Paul Nicolo ◽  
Judy Nation ◽  
Patrick Kwan ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Ketogenic Diet ◽  
Diet Therapy ◽  
Refractory Status Epilepticus ◽  
Current Evidence ◽  
Dietary Therapy ◽  
Effective Treatment Option ◽  
Acute Setting ◽  
Refractory Status ◽  
Metabolic Interactions

ABSTRACTPURPOSE OF REVIEWKetogenic diet therapy can be utilized as an adjuvant treatment of super refractory status epilepticus (SRSE). However, the drug and metabolic interactions with concomitant treatments present a challenge for clinicians. In this review we focus on the practical considerations of implementing ketogenic dietary therapy in the acute setting, including the dietary composition, potential drug-diet interactions, and monitoring during ketogenic treatment.RECENT FINDINGSThis report describes the ketogenic diet therapy protocol implemented for the treatment of SRSE and a review of the current evidence to support clinical practice.SUMMARYThe control of SRSE is critical in reducing morbidity and mortality. There is emerging evidence that ketogenic diet may be a safe and effective treatment option for these patients.

Ketogenic Diet in Status Epilepticus

2016 ◽  
Author(s):  
Rima Nabbout
Keyword(s):  
Intensive Care ◽  
Status Epilepticus ◽  
Intensive Care Units ◽  
Ketogenic Diet ◽  
Significant Risk ◽  
Refractory Status Epilepticus ◽  
Dietary Therapy ◽  
Risk Of Death ◽  
Refractory Status ◽  
Neurological Morbidity

Refractory status epilepticus (RSE) is associated with a significant risk of death or neurological morbidity. The ketogenic diet (KD) is a dietary therapy that succeeds in controlling seizures in otherwise RSE in children and adult patients. Inflammatory etiologies might be a particular target, but KD has reported efficacy in other etiologies. KD is well tolerated, and the effect is seen within days. Randomized and controlled studies are lacking in this area, and studies are needed to prove the efficacy of KD in RSE and to identify specific indications. This would help to increase its use and to implement it in intensive care units to resolve severe epileptic conditions quickly.

scholarly journals Ketogenic diet for super-refractory status epilepticus: A case series and review of literature

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
VimalKumar Paliwal ◽  
Sucharita Anand ◽  
AmarS Vibhute ◽  
Ananya Das ◽  
Shilpi Pandey
Keyword(s):  
Status Epilepticus ◽  
Ketogenic Diet ◽  
Case Series ◽  
Refractory Status Epilepticus ◽  
Review Of Literature ◽  
Refractory Status

Combination of ketogenic diet and stiripentol for super-refractory status epilepticus: A case report

2017 ◽  
Vol 373 ◽  
pp. 35-37 ◽  
Author(s):  
Yuto Uchida ◽  
Daisuke Kato ◽  
Takanari Toyoda ◽  
Masahiro Oomura ◽  
Yoshino Ueki ◽  
...  
Keyword(s):  
Case Report ◽  
Status Epilepticus ◽  
Ketogenic Diet ◽  
Refractory Status Epilepticus ◽  
Refractory Status

The Ketogenic Diet for Medically and Surgically Refractory Status Epilepticus in the Neurocritical Care Unit

2011 ◽  
Vol 15 (3) ◽  
pp. 519-524 ◽  
Author(s):  
Mackenzie C. Cervenka ◽  
Adam L. Hartman ◽  
Arun Venkatesan ◽  
Romergryko G. Geocadin ◽  
Eric H. Kossoff
Keyword(s):  
Status Epilepticus ◽  
Ketogenic Diet ◽  
Neurocritical Care ◽  
Refractory Status Epilepticus ◽  
Refractory Status

scholarly journals Intravenous initiation and maintenance of ketogenic diet: Proof of concept in super-refractory status epilepticus

Seizure ◽  
2013 ◽  
Vol 22 (7) ◽  
pp. 581-583 ◽  
Author(s):  
Adam Strzelczyk ◽  
Philipp S. Reif ◽  
Sebastian Bauer ◽  
Marcus Belke ◽  
Wolfgang H. Oertel ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Ketogenic Diet ◽  
Refractory Status Epilepticus ◽  
Proof Of Concept ◽  
Refractory Status

scholarly journals Unexpected Aphasia following Right Temporal Lobectomy as Treatment of Recurrent Super-Refractory Status Epilepticus

2017 ◽  
Vol 9 (2) ◽  
pp. 195-203
Author(s):  
Utku Uysal ◽  
Patrick Landazuri ◽  
Caleb Pearson ◽  
Manoj Mittal ◽  
Nancy Hammond
Keyword(s):  
Status Epilepticus ◽  
Recovery Period ◽  
Refractory Status Epilepticus ◽  
Temporal Lobectomy ◽  
Effective Treatment Option ◽  
Modest Improvement ◽  
Refractory Status ◽  
Sensory Aphasia ◽  
Stepwise Reduction ◽  
Crossed Aphasia

Background: Super-refractory status epilepticus (SRSE) is a critical neurological condition with a high mortality rate. There are only limited data to direct the treatment in SRSE, and surgery has been reported to successfully stop SRSE. We present a case of recurrent SRSE treated with urgent right temporal lobectomy in a right-handed woman which potentially saved her life but resulted in crossed sensory aphasia. Case Description: A 61-year-old woman with a recent episode of prolonged focal SRSE due to right frontotemporal meningioma and hyperkalemia was admitted for recurrence of seizures that evolved to SRSE despite aggressive treatment with multiple fosphenytoin antiepileptic drugs (AEDs) and anesthetics. The patient underwent a right temporal lobectomy to remove the encephalomalacic and gliotic tissue around the meningioma that had been resected during a previous admission. Postoperatively the patient had a protracted course with modest improvement after stepwise reduction in her AEDs; however, her recovery unveiled a severe crossed aphasia. Conclusion: Resective surgery is an effective treatment option in the treatment of SRSE, although the recovery period can be protracted. Crossed aphasia after right temporal lobectomy should be considered in patients where it is not possible to complete a presurgical evaluation of higher cortical functions.

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