The Ketogenic Diet in the Treatment of Childhood Epilepsy

2010 ◽  
Vol 5 (1) ◽  
pp. 88
Author(s):  
J Helen Cross ◽  
Keyword(s):  
Ketogenic Diet ◽  
Evidence Base ◽  
Drug Resistant ◽  
Older Children ◽  
Efficacy Evaluation ◽  
Anti Epileptic Drug ◽  
Drug Resistant Epilepsy ◽  
Randomised Controlled

The ketogenic diet has been used for the treatment of drug-resistant epilepsy in childhood for almost 100 years. This aside, it is only over the past decade that renewed interest has led to a further evidence base for efficacy, evaluation of optimal implementation and wider discussion of possible mechanisms of action. Randomised controlled data have now demonstrated the diet to be as effective as any newer anti-epileptic drug (AED) in drug-resistant epilepsy. Implementation can be challenging, and is resource-intensive, but successful use can lead to improved quality of life with most immediate side effects alleviated by dietary manipulation. However, data are still required on the choice of optimal candidates and the role of alternative diets in older children.

scholarly journals Refractory Epilepsy: Mechanisms of Pharmacoresistance

2021 ◽  
pp. 99-110
Author(s):  
Ariel Le ◽  
Makenzie Thomas ◽  
Brady Stallman ◽  
Kathryn Meadows ◽  
Vidya Bhargava
Keyword(s):  
Blood Brain Barrier ◽  
Refractory Epilepsy ◽  
Treatment Options ◽  
Brain Barrier ◽  
Drug Resistant ◽  
Blood Brain ◽  
Anti Epileptic Drug ◽  
Drug Resistant Epilepsy ◽  
Protein Transporters

Refractory or drug-resistant epilepsy is a complex and debilitating disorder that impacts over one-third of people diagnosed with epilepsy. Many studies have suggested a variety of possible hypotheses for drug-resistant epilepsy, including the degeneration of neural networks, alterations of anti-epileptic drug (AED) targets, intrinsic severity/frequency of seizures, and genetic predisposition to pharmacoresistance. However, extensive research suggests that the overexpression of efflux protein transporters in brain tissue is the most viable hypothesis. Specifically, the overexpression of P-glycoproteins (P-gps) at the blood brain barrier proves the most compelling mechanism to discuss further. Studying the mechanisms of these transporters provides critical insight for new ways to combat pharmacoresistance. Thus, this review evaluates the co-administration of P-gp inhibitors with AEDs as a promising, yet relatively unexplored, treatment option for refractory epilepsy. This review specifically considers Tariquidar (TQD) the most promising P-gp inhibitor for refractory epilepsy treatment. This work aims to evaluate the role of P-gp overexpression in refractory epilepsy, consolidate current research about potential treatment options, and identify discrepancies or gaps in the literature related to P-gp inhibitory treatments for refractory epilepsy. It was concluded that, as a result of increased drug efflux processes at the blood brain barrier, overexpression of P-gp is the leading cause of pharmacoresistance. By inhibiting the activity of these proteins with the drug Tariquidar, an effective treatment for refractory epilepsy may become a reality.

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.

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

Fifteen-minute consultation: When medicines don’t work—the child with poorly controlled seizures

2018 ◽  
Vol 104 (3) ◽  
pp. 135-140
Author(s):  
Pooja Harijan ◽  
Arnab Kumar Seal ◽  
Manish Prasad ◽  
William P Whitehouse
Keyword(s):  
Quality Of Life ◽  
Epilepsy Surgery ◽  
Drug Resistant ◽  
Algorithmic Approach ◽  
Life Management ◽  
Drug Resistant Epilepsy

Drug-resistant epilepsy (DRE) occurs in 20%–30% of children with epilepsy with significant impact on their quality of life. Management of this group of children has greatly improved in the recent years with streamlining of epilepsy surgery services and associated quaternary multimodal evaluation. This article provides a review of DRE in children and management based on recent evidence and published opinion. We have also presented an algorithmic approach to the child with possible DRE.

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
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