The impact of early versus late anticonvulsant reduction after ketogenic diet initiation

Kossoff, Eric H.; Pyzik, Paula L.; McGrogan, Jane R.; Rubenstein, James E.

doi:10.1016/j.yebeh.2004.03.011

Cited by 48 publications

(42 citation statements)

References 11 publications

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“…Several studies have reported a reduction >50% of seizures in at least half of children and adolescents subjected to this treatment 18,19 . These clinical benefits go beyond seizure control since many children and adolescents can benefit from reducing the use of anti-epileptic drugs (number and dose of drugs) 20 . These effects are considered of great clinical significance since seizures are associated with brain damage and have a negative impact on neurobiological and cognitive aspects.…”

Section: Discussionmentioning

confidence: 99%

Ketogenic food pyramid for patients with refractory epilepsy: From theory to clinical practice

et al. 2017

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Objective: To develop a graphical representation in the form of a food pyramid for a ketogenic diet for dietary treatment in children and adolescents with refractory epilepsy. Methods: The pyramid was constructed based on: the estimation of energy requirements for different age groups, macronutrient distribution, food groups, and the number of servings and respective amounts of food according to the ketogenic diet. Serving sizes were based on the calculation of energy and macronutrient requirements according to age and nutritional status. Results: The pyramid was divided into three tiers and 5 food groups (fats, proteins, type 1 vegetables, type 2 vegetables, and fruits). Four portion size lists were defined for the following age groups: 1-3 years, 4-6 years, 7-10 years, and 11-19 years. Conclusion: The ketogenic diet food pyramid can be used as nutritional guidance for patients undergoing this dietary therapy by illustrating the variety of foods that can be eaten during the treatment, optimizing adherence to the treatment, and guaranteeing beneficial effects on seizure control.

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Section: Discussionmentioning

confidence: 99%

Ketogenic food pyramid for patients with refractory epilepsy: From theory to clinical practice

et al. 2017

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“…Medical records were reviewed with respect to demographic data, seizure type, epilepsy syndrome, age at seizure and KD onset, seizure frequency, number of anticonvulsants tried prior to starting the KD, and specific anticonvulsants taken while on the KD. Based on previous data, we decided to examine outcomes of children on the diet at 3 months to allow for only diet adjustment and the highest likelihood of observing improvement (Kossoff et al., 2008a), but also because most children had medication adjustment by the 6‐month diet duration period (Kossoff et al., 2004).…”

Section: Methodsmentioning

confidence: 99%

The influence of concurrent anticonvulsants on the efficacy of the ketogenic diet

et al. 2009

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SUMMARYIt is unknown if any particular anticonvulsants modify the likelihood of seizure reduction when used in combination with the ketogenic diet (KD). A retrospective study was performed of 217 consecutive children who started the KD from 2000-2007. Patients included did not have any changes to their anticonvulsant dose. Efficacy data at 3 months on the KD were analyzed with respect to the six most frequently used anticonvulsants in this cohort. A total of 115 patients were included. Children receiving phenobarbital in combination with the KD were significantly less likely to have a >50% seizure reduction (p = 0.003). Conversely, those receiving zonisamide in combination with the KD at onset were more likely to have a >50% reduction (p = 0.04). These results provide practical information to clinicians who are treating children receiving both the KD and anticonvulsants.

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“…AEİ'ların kesilmesi KD'in başlıca amaçlarından biridir ve başarılı olduktan birkaç ay içinde başlanır (31) . Fenobarbital ve benzodiazepinler kesilirken nöbet artışı daha fazla olabilir, bu nedenle daha dikkatli olunmalıdır.…”

Section: İlaçlar Ve Ketojenik Diyetunclassified

Ketogenic diet practices on childhood epilepsies

Ünalp¹

2017

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ÖZKetojenik diyet çocukluk çağının dirençli epilepsilerinin nonfarmakolojik tedavisinde etkili olması için geliştirilmiştir. Buna ilaveten glukoz transport bozukluğu-1 sendromu gibi bazı metabolik hastalıkların tedavisinde 1. seçenek tedaviyi oluşturmaktadır. Büyüme ve laboratuvar değerlerinin yakından izlenmesi gereklidir. Bu nedenle bu çocuklarla ilgilenen çocuk hekimlerinin de diyetle ilgili yeterli bilgisinin olması gerekmektedir. Ketojenik diyetin nöbetleri kontrol edici etkisinin mekanizması halen aktif olarak araştırılmaktadır fakat birçok teori öne sürülmüştür. Aralık 2006'da Charli Derneği ketojenik diyet kullanımında deneyimli olan 9 ülkeden 26 pediatrik epileptolojist ve diyetisyenrden oluşan bir komisyon ile panel yapmıştır. Bu grup KD'in klinik yönetimiyle ilgili konsensus geliştirdi. Bu makalede KD'in nöbete karşı olan etki mekanizmaları, klinik endikasyon ve kontrendikasyonları tartışılacaktır. Hasta seçi-mi, KD öncesi danışma ve değerlendirme, KD tipinin seçilmesi, uygulama, eklemeler, izlem ve yan etkilerin yönetimi basamaklarından oluşmaktadır. KD alan çocuğun izlenmesi sırasında pediatrik nörolog, pediatrist ve diyetisyenin birlikte göstereceği çaba KD tedavisinin başarısını ve oluşabilecek yan etkilerin tanınması, korunması ve giderilmesinde esastır. Bu derlemede, genel pediatristlerin KD kullanan çocukların bakımıyla ilgili bilmeleri gereken becerileri arttırarak çocuğun aile ve bakıcılarına danışma vermesini sağlayacaktır.Anahtar kelimeler: Ketojenik diyet, çocukluk çağı, dirençli nöbet, konsensus ABSTRACTKetogenic diet is a non-pharmacologic treatment developed to be effective in childhoodresistant epilepsy. It is also the first-line treatment for many of these metabolic diseases such as deficiency of glucose transporter 1. Growth and laboratory values need to be closely monitored. For this reason, pediatricians interested in these children should also have adequate knowledge of the diet. The mechanism of the seizure-controlling effect of ketogenic diet is still actively being investigated, but many theories have been proposed. In December 2006, the Charli Association organized a panel with a commission of 26 pediatric epileptologists and dietitians from 9 countries experienced in the use of ketogenic diet. This group has developed a consensus on the clinical management of KD. In this article, the mechanism of neuroprotective action of KD, clinical indications and contraindications will be discussed. Patient selection consists of phases of counseling and evaluation before use of KD, selection of the type of KD, its administration, supplementations, follow-up and management of side effects. The combined effort of the pediatric neurologist, pediatrician and dietician during the monitoring of the child receiving KD is essential in the recognition, protection and elimination of the success of the KD treatment and its possible side effects. In this review, general pediatricians will be able to provide advice to the child's family and caregivers by increasing the skills they need to know about t...

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The impact of early versus late anticonvulsant reduction after ketogenic diet initiation

Cited by 48 publications

References 11 publications

Ketogenic food pyramid for patients with refractory epilepsy: From theory to clinical practice

Ketogenic food pyramid for patients with refractory epilepsy: From theory to clinical practice

The influence of concurrent anticonvulsants on the efficacy of the ketogenic diet

Ketogenic diet practices on childhood epilepsies

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