Intravenous ketogenic diet: guidelines for ketogenic parenteral therapy

Kossoff, Eric H.

doi:10.1111/dmcn.14305

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…The ketogenic diet (KD) is a high-fat, low-carbohydrate, and moderate protein content and has been used to treat children with refractory epilepsy since the 1920s, with a resurgence in the past two decades [ 6 ]. Putative mechanisms of KD include anti-inflammatory effects and neuroprotective properties in addition to anticonvulsant effects [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Ketogenic Diet for a Young Adult Patient With Chronic-Phase Febrile Infection-Related Epilepsy Syndrome

Obara

Ono

2022

Cureus

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Febrile infection-related epilepsy syndrome (FIRES) is a rare disease, whereby refractory status epilepticus (a severe epileptic syndrome) occurs in previously healthy individuals following a febrile illness. Here, we report a patient with FIRES who received ketogenic diet (KD) therapy initiated in the chronic phase. A 21-year-old man presented with status epilepticus, following fever and headache. In the acute phase, his seizures were refractory to conventional antiepileptic drugs and were suppressed only by intravenous anesthetics. In the chronic phase, he showed frequent seizures with concurrent severe cognitive decline. Twenty-seven months after onset, the patient was started on KD. Consequently, his seizure frequency rapidly reduced while his cognitive function slowly improved, albeit incompletely. Recently, KD has been shown to both reduce seizures and improve cognitive prognoses in children with FIRES. Although early KD may help in both seizure control and cognitive prognosis, it is likely that KD can be applied to adult patients with chronic FIRES.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ketogenic Diet for a Young Adult Patient With Chronic-Phase Febrile Infection-Related Epilepsy Syndrome

Obara

Ono

2022

Cureus

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New-onset refractory status epilepticus (NORSE)

Ritter

Nashef

2021

Pract Neurol

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New-onset refractory status epilepticus and its subcategory febrile infection-related epilepsy syndrome are rare devastating clinical presentations in those without pre-existing relevant history, often in schoolchildren or young adults, without a clear cause on initial investigations. A cause is later identified in up to half of adults, but in many fewer children. Patients often require protracted intensive care and are at significant risk of dying. Functional disability is common and subsequent chronic epilepsy is the norm, but some people do have good outcomes, even after prolonged status epilepticus. Patients need prompt investigations and treatment. Anaesthetic and antiseizure medications are supplemented by other treatment modalities, including the ketogenic diet. Despite limited evidence, it is appropriate to try to modify the presumed underlying pathogenesis with immune modulation early, with a more recent focus on using interleukin inhibitors. Optimising management will require concerted multicentre international efforts.

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Intravenous ketogenic diet: guidelines for ketogenic parenteral therapy

Cited by 2 publications

References 7 publications

Ketogenic Diet for a Young Adult Patient With Chronic-Phase Febrile Infection-Related Epilepsy Syndrome

Ketogenic Diet for a Young Adult Patient With Chronic-Phase Febrile Infection-Related Epilepsy Syndrome

New-onset refractory status epilepticus (NORSE)

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