Efficacy and safety of ketogenic diet for treatment of pediatric convulsive refractory status epilepticus.
Epilepsy Res
; 144: 1-6, 2018 08.
Article
en En
| MEDLINE
| ID: mdl-29727818
ABSTRACT
PURPOSE:
To describe the efficacy and safety of ketogenic diet (KD) for convulsive refractory status epilepticus (RSE).METHODS:
RSE patients treated with KD at the 6/11 participating institutions of the pediatric Status Epilepticus Research Group from January-2011 to December-2016 were included. Patients receiving KD prior to the index RSE episode were excluded. RSE was defined as failure of ≥2 anti-seizure medications, including at least one non-benzodiazepine drug. Ketosis was defined as serum beta-hydroxybutyrate levels >20â¯mg/dl (1.9â¯mmol/l). Outcomes included proportion of patients with electrographic (EEG) seizure resolution within 7â¯days of starting KD, defined as absence of seizures and ≥50% suppression below 10⯵V on longitudinal bipolar montage (suppression-burst ratio ≥50%); time to start KD after onset of RSE; time to achieve ketosis after starting KD; and the proportion of patients weaned off continuous infusions 2 weeks after KD initiation. Treatment-emergent adverse effects (TEAEs) were also recorded.RESULTS:
Fourteen patients received KD for treatment of RSE (median age 4.7 years, interquartile range [IQR] 5.6). KD was started via enteral route in 11/14 (78.6%) patients. KD was initiated a median of 13â¯days (IQR 12.5) after the onset of RSE, at 41 ratio in 8/14 (57.1%) patients. Ketosis was achieved within a median of 2â¯days (IQR 2.0) after starting KD. EEG seizure resolution was achieved within 7â¯days of starting KD in 10/14 (71.4%) patients. Also, 11/14 (78.6%) patients were weaned off their continuous infusions within 2 weeks of starting KD. TEAEs, potentially attributable to KD, occurred in 3/14 (21.4%) patients, including gastro-intestinal paresis and hypertriglyceridemia. Three month outcomes were available for 12/14 (85.7%) patients, with 4 patients being seizure-free, and 3 others with decreased seizure frequency compared to pre-RSE baseline.CONCLUSIONS:
This series suggests efficacy and safety of KD for treatment of pediatric RSE.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Estado Epiléptico
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Dieta Cetogénica
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Epilepsia Refractaria
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Año:
2018
Tipo del documento:
Article