Metabolic Treatments for Intractable Epilepsy

Kelley, Sarah A.; Hartman, Adam L.

doi:10.1016/j.spen.2011.06.004

Cited by 17 publications

(22 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar results have been reported in two retrospective studies of the LGIT, with 38%–73% of patients achieving >50% seizure reduction 70,71. The best candidates for the MAD tend to be adults and adolescents, for whom compliance on the LCFA and MCT diets is an issue 64. This is because the food consumed on the MAD is similar to that being consumed by peers.…”

Section: Non-pharmacological Optionssupporting

confidence: 78%

“…Typically the patient must consume 3–4 grams of fat for every 1 gram of carbohydrate plus protein. As a result, between 86% and 90% of the calories from this diet are provided from lipids 64. The MCT diet provides more ketones per calorie consumed than in the classic ketogenic diet, which uses mainly LCFAs.…”

Section: Non-pharmacological Optionsmentioning

confidence: 99%

“…The most common side effects of dietary treatments are constipation, acidosis, temporary hypercholesterolemia, kidney stones and hunger 64. Growth restriction has also been observed in children 77.…”

Section: Non-pharmacological Optionsmentioning

confidence: 99%

See 2 more Smart Citations

Pharmacotherapeutic and Non-Pharmacological Options for Refractory and Difficult-to-Treat Seizures

Mitchell

Seri

Cavanna

2012

J Cent Nerv Syst Dis

View full text Add to dashboard Cite

It is currently estimated that about 20%–30% of adults and 10%–40% of children diagnosed with epilepsy suffer from uncontrolled or poorly controlled seizures, despite optimal medical management. In addition to its huge economic costs, treatment-refractory epilepsy has a widespread impact on patients’ health-related quality of life. The present paper focuses on the concepts of refractory and difficult-to-treat seizures and their pharmacological management. Evidence on efficacy and tolerability of rational pharmacotherapy with antiepileptic drug combinations and of non-pharmacological treatment options such as epilepsy surgery, neurostimulation, metabolic treatment and herbal remedies is reviewed. The importance of early identification of the underlying etiology of the specific epilepsy syndrome is emphasized, to inform early prognosis and therapeutic strategies.

show abstract

Section: Non-pharmacological Optionssupporting

confidence: 78%

Section: Non-pharmacological Optionsmentioning

confidence: 99%

See 1 more Smart Citation

Pharmacotherapeutic and Non-Pharmacological Options for Refractory and Difficult-to-Treat Seizures

Mitchell

Seri

Cavanna

2012

J Cent Nerv Syst Dis

View full text Add to dashboard Cite

show abstract

“…KDs enhanced athletic outcomes (Phinney et al, 1983; Volek et al, 2016) and reversed motor deficits in a model of amyotrophic lateral sclerosis (Zhao et al, 2012). Recently, KDs have been considered a potential therapeutic approach to neurological disorders (Kashiwaya et al, 2000; Prins, 2008; Puchowicz et al, 2008; Kelley and Hartman, 2011; Kim et al, 2012; Choi et al, 2016). Its neuroprotective effects can be associated with the ability of ketone bodies to act as additional energy substrates (Keon et al, 1995), replacing glucose as the brain's main energy source (Cahill, 2006; Masino et al, 2009; Courchesne-Loyer et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Nutritional Ketosis Affects Metabolism and Behavior in Sprague-Dawley Rats in Both Control and Chronic Stress Environments

Brownlow

Jung

Moore

et al. 2017

Front. Mol. Neurosci.

View full text Add to dashboard Cite

Nutritional ketosis may enhance cerebral energy metabolism and has received increased interest as a way to improve or preserve performance and resilience. Most studies to date have focused on metabolic or neurological disorders while anecdotal evidence suggests that ketosis may enhance performance in the absence of underlying dysfunction. Moreover, decreased availability of glucose in the brain following stressful events is associated with impaired cognition, suggesting the need for more efficient energy sources. We tested the hypotheses that ketosis induced by endogenous or exogenous ketones could: (a) augment cognitive outcomes in healthy subjects; and (b) prevent stress-induced detriments in cognitive parameters. Adult, male, Sprague Dawley rats were used to investigate metabolic and behavioral outcomes in 3 dietary conditions: ketogenic (KD), ketone supplemented (KS), or NIH-31 control diet in both control or chronic stress conditions. Acute administration of exogenous ketones resulted in reduction in blood glucose and sustained ketosis. Chronic experiments showed that in control conditions, only KD resulted in pronounced metabolic alterations and improved performance in the novel object recognition test. The hypothalamic-pituitary-adrenal (HPA) axis response revealed that KD-fed rats maintained peripheral ketosis despite increases in glucose whereas no diet effects were observed in ACTH or CORT levels. Both KD and KS-fed rats decreased escape latencies on the third day of water maze, whereas only KD prevented stress-induced deficits on the last testing day and improved probe test performance. Stress-induced decrease in hippocampal levels of β-hydroxybutyrate was attenuated in KD group while both KD and KS prevented stress effects on BDNF levels. Mitochondrial enzymes associated with ketogenesis were increased in both KD and KS hippocampal samples and both endothelial and neuronal glucose transporters were affected by stress but only in the control diet group. Our results highlight the complex relationship between peripheral metabolism, behavioral performance and biochemical changes in the hippocampus. Endogenous ketosis improved behavioral and metabolic parameters associated with energy metabolism and cognition while ketone supplementation replicated the biochemical effects within the hippocampus but only showed modest effects on behavioral improvements.

show abstract

“…KD is based on the ingestion of very low-carbohydrate diet and one hypothesis of KD efficacy predicts that KD-induced seizure control might depend on the inhibition of glycolysis and carbohydrate metabolism. In support of this view, the administration of the glycolysis inhibitor 2-deoxy-D-glucose (2DG) is reported to induce both in vitro and in vivo anticonvulsant actions by reducing pharmacologically-induced interictal epileptiform bursting in hippocampal slices as well as 6Hz stimulation-evoked seizures in mice and the progression of epileptogenesis in kindling model of TLE in rats [139,140]. Despite the large number of availableAEDs, several epilepsy syndromes are medically intractable and TLE shows one of the worst prognoses.…”

Section: Novel Therapeutic Options For Epilepsy Management and Gene Tmentioning

confidence: 95%

Targeted Resequencing of Epilepsy Genes: A Pharmaco-Therapeutic Perspective

Moles¹,

Romanelli²,

Zara³

et al. 2014

Int J Neurorehabilitation Eng

View full text Add to dashboard Cite

More than half of all epilepsies have some genetic basis and single gene defects in ion channels or neurotransmitter receptors are associated with some inherited forms of epilepsy. Genetic research even in the field of epilepsy disorders is increasing in term of testing platform for the investigation of sequence and structural variation. Next generation sequencing (NGS), i.e., high-throughput sequencing technologies now allow analyses that were previously prohibitive. Targeted resequencing methods by diagnostic panels enable to sequence all the genes associated with a certain disease simultaneously within a few weeks. In this review, we will discuss the overall helpfulness and convenience of simultaneous genotyping of multiple epilepsy genes by NGS in a pharmacogenetics perspective.

show abstract

Metabolic Treatments for Intractable Epilepsy

Cited by 17 publications

References 61 publications

Pharmacotherapeutic and Non-Pharmacological Options for Refractory and Difficult-to-Treat Seizures

Pharmacotherapeutic and Non-Pharmacological Options for Refractory and Difficult-to-Treat Seizures

Nutritional Ketosis Affects Metabolism and Behavior in Sprague-Dawley Rats in Both Control and Chronic Stress Environments

Targeted Resequencing of Epilepsy Genes: A Pharmaco-Therapeutic Perspective

Contact Info

Product

Resources

About