The efficacy of the ketogenic diet in infants and young children with refractory epilepsies using a formula-based powder

Ashrafi, Mahmoud Reza; Zamani, Gholamreza; Mohammadi, Mahmoud; Tavassoli, Alireza; Badv, Reza Shervin; Heidari, Morteza; Karimi, Parviz; Malamiri, Reza Azizi

doi:10.1007/s13760-016-0732-0

Cited by 15 publications

(12 citation statements)

References 18 publications

(35 reference statements)

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“…In our study, 83.70% patients followed a 2:1 KD ratio, and 78.26% responded to the KD by the rst month of treatment. Our ndings are consistent with those of some previous studies [10][11][12][13] but different from others [14,15] . Our study included a greater number of children who exhibited improvement and whose seizures were managed while following the 2:1 KD ratio.…”

Section: Discussionsupporting

confidence: 84%

Efficacy and safety of a ketogenic diet in children with drug-resistant epilepsy

Wang¹,

Jiang²,

Guo³

et al. 2020

Preprint

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Background: To prospectively evaluate the efﬁcacy and safety of a ketogenic diet (KD) in managing seizures in children with drug-resistant epilepsy and identify factors influencing its efﬁcacy in a Chinese cohort. Methods: Ninety-two pediatric patients (55 males, 37 females), aged 3 months to 10 years (29.26±24.18 months), with drug-resistant epilepsy who followed a KD for 1-12 months were included. The efficacy of the KD was evaluated by assessing the seizure frequency, as reported by parents/caregivers. The effects of demographic and clinical variables on patients’ duration on the KD were analyzed.Results: At the 1-, 3-, 6-, and 12-month follow-ups, 78.26%, 75%, 80%, and 93.10% of patients were responsive to KD therapy, respectively. Five non-responders at 3 months became responsive by 6 months. Age, disease duration, seizure type, etiology, anti-epileptic drug (AED) type, and KD ratio did not affect treatment efﬁcacy. After the KD, changes in AEDs and electroencephalography and imaging findings were statistically significant (p<0.05). Only 4.34% patients experienced complications requiring medical intervention. Conclusions: KD is an effective and well-tolerated therapy for children with drug-resistant epilepsy. The KD adherence rate largely depends on its efﬁcacy. Genetic information relating to the diet response and synergistic effect between KD and AEDs requires further study. Clinical trial has registered at Chinese clinical trial registry: http://www.chictr.org.cnRegistration numbers: ChiCTR2000031394. Date: (30/03/2020)Availability of data and material: http://www.medresman.org.cn/uc/index.aspxCode availability (software application or custom code): ziyan030815, wangjuan030815

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Section: Discussionsupporting

confidence: 84%

Efficacy and safety of a ketogenic diet in children with drug-resistant epilepsy

Wang¹,

Jiang²,

Guo³

et al. 2020

Preprint

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“…In this sense, prolonged seizures or status epilepticus in epilepsy patients can become a serious problem due to their consequences on the quality life from this population [50]. Seizures can have devastating consequences and, as result, suffer bodily injury requiring hospitalization.…”

Section: Resultsmentioning

confidence: 99%

“…Seizures can have devastating consequences and, as result, suffer bodily injury requiring hospitalization. Others have shortened life span due to the increased risk of unexpected sudden death that is associated with uncontrolled seizures [50][51][52]. Studies have shown that patients with epilepsy can be significant neuropsychological, psychiatric, and social impairments that limit employment, reduce marriage rates, and decrease quality of life [51][52][53].…”

Section: Resultsmentioning

confidence: 99%

Apoptotic Markers Are Increased in Epilepsy Patients: A Relation with Manganese Superoxide Dismutase Ala16Val Polymorphism and Seizure Type through IL-1β and IL-6 Pathways

Kegler

Caprara

Pascotini

et al. 2020

BioMed Research International

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The MnSOD Ala16Val single nucleotide polymorphism (SNP) has been associated with different diseases. However, there are scarcely studies relating this SNP in epilepsy, a neurologic disease that involves some interacting pathways, such as apoptotic and inflammatory factors. In this sense, we decided to investigate the relationship of MnSOD Ala16Val SNP with apoptotic markers in epilepsy and its relation with inflammatory pathway and seizure type. Ninety subjects were evaluated (47 epilepsies; 43 controls) by questionnaires and laboratorial exams. We observed a higher percentage of VV genotype in the epilepsy group when compared to the control group. IL-1β, IL-6, caspase-1, and caspase-3 levels were increased in the epilepsy group (VV genotype). Furthermore, an important correlation between IL-1β vs. caspase-1 and IL-6 vs. caspase-3 was observed in the epilepsy group (VV genotype). The epilepsy group which presented generalized seizures also demonstrated a positive correlation between IL-1β vs. CASP1 and IL-6 vs. CASP3. Thus, it is a plausible propose that epilepsy patients with VV genotype and generalized seizures present a worse inflammatory and apoptotic status. Our findings suggest that the knowledge of MnSOD Ala16Val polymorphism existence is important to evaluate molecular mechanisms associated to seizure and improve the treatment of these patients.

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“…For older children and adults, it can be used as a meal substitute and in combination with solid foods, to increase the KR of a meal or to supplement it with vitamins and minerals. Several studies have shown that the use of powder ketogenic formula in KDs is effective, safe, and tolerable for infants and children suffering refractory seizures [119,120]. In a recent study, 27 infants and children with drug-refractory epilepsy, aged between 12 months and five years, were treated with a powder ketogenic formula for four months.…”

Section: Food Products For the Ketogenic Dietmentioning

confidence: 99%

Food and Food Products on the Italian Market for Ketogenic Dietary Treatment of Neurological Diseases

et al. 2019

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The ketogenic diet (KD) is the first line intervention for glucose transporter 1 deficiency syndrome and pyruvate dehydrogenase deficiency, and is recommended for refractory epilepsy. It is a normo-caloric, high-fat, adequate-protein, and low-carbohydrate diet aimed at switching the brain metabolism from glucose dependence to the utilization of ketone bodies. Several variants of KD are currently available. Depending on the variant, KDs require the almost total exclusion, or a limited consumption of carbohydrates. Thus, there is total avoidance, or a limited consumption of cereal-based foods, and a reduction in fruit and vegetable intake. KDs, especially the more restrictive variants, are characterized by low variability, palatability, and tolerability, as well as by side-effects, like gastrointestinal disorders, nephrolithiasis, growth retardation, hyperlipidemia, and mineral and vitamin deficiency. In recent years, in an effort to improve the quality of life of patients on KDs, food companies have started to develop, and commercialize, several food products specific for such patients. This review summarizes the foods themselves, including sweeteners, and food products currently available for the ketogenic dietary treatment of neurological diseases. It describes the nutritional characteristics and gives indications for the use of the different products, taking into account their metabolic and health effects.

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The efficacy of the ketogenic diet in infants and young children with refractory epilepsies using a formula-based powder

Cited by 15 publications

References 18 publications

Efficacy and safety of a ketogenic diet in children with drug-resistant epilepsy

Efficacy and safety of a ketogenic diet in children with drug-resistant epilepsy

Apoptotic Markers Are Increased in Epilepsy Patients: A Relation with Manganese Superoxide Dismutase Ala16Val Polymorphism and Seizure Type through IL-1β and IL-6 Pathways

Food and Food Products on the Italian Market for Ketogenic Dietary Treatment of Neurological Diseases

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