Use of the ketogenic diet in an adult with myoclonic status epilepticus

Cash, C.

doi:10.1016/j.clnesp.2015.03.053

Cited by 3 publications

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“…In addition to the above‐mentioned studies, there were 13 case reports and series that reported KD use in a total of 17 adult patients, six of those reported male . The age of patients ranged from 19 to 58 years.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the above-mentioned studies, there were 13 case reports and series that reported KD use in a total of 17 adult patients, six of those reported male. 6,[25][26][27][28][29][30][31][32][33][34][35][36] The age of patients ranged from 19 to 58 years. There were four Patients with a reported history of seizures/epilepsy.…”

Section: Effectiveness Of Kd In Adults With Sementioning

confidence: 99%

Systematic review of ketogenic diet use in adult patients with status epilepticus

2019

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Status epilepticus (SE) is a medical emergency that is associated with a significant morbidity and mortality. Recently, there has been significant interest in the use of ketogenic diets (KD) in the management of SE. KD is a high‐fat, low‐carbohydrate, and adequate protein diet that has been shown to be a safe and effective adjuvant to present SE management in patients with refractory epilepsy. Many case reports and case series have demonstrated the potential safety and effectiveness of KD for the acute treatment of SE; however, quality studies remain scarce on this topic. The purpose of this systematic review is to summarize the available evidence for the safety and effectiveness of KD in adults with SE. A literature search was performed in MEDLINE, EMBASE, Cochrane Library, and CINAHL (September 14, 2018). The search was repeated on March 27, 2019, to include any studies published since the original search. Keywords related to KD and SE were used. Studies were selected based on the reported use of the KD in SE. The search resulted in a total of 954 records. After screening and full‐text review, 17 articles were included in this review: four observational studies, 10 case reports, and 3 case series. Based on the observational studies, a total of 38 Patients with SE have been reported. KD was successful in achieving cessation of SE in 31 Patients (82%). The most common adverse effects reported were metabolic acidosis, hyperlipidemia, and hypoglycemia. The current limited evidence suggests that KD might be considered as an option for adult patients with SE. Although promising, the results need to be interpreted with caution due to the inherent bias, confounding and small sample size of the included studies. A randomized controlled trial is recommended to establish role of KD in the management of SE in adults.

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“…In adults, the age varied between 18 -82 years, with 2 patients of 18 years old reported by Villeneuve in 2009 and Cervenka in 2017 [8,39]. The average age of the 35 patients was 40.3 years, one patient did not have the age mentioned ("middle-aged") [4]. Out of the total number of adult patients 22 were females and 14 males.…”

Section: Analysed Datamentioning

confidence: 98%

“…Out of the total number of adult patients 22 were females and 14 males. There were 2 types of status epilepticus reported, generalised and focal motor, with 2 exception, one case of myoclonic status epilepticus and one case of nonconvulsive status epilepticus (NCSE) [4,21]. Regarding the underlying aetiology, 5 out of 36 cases (~14%) were encephalitis of unknown aetiology or NORSE (new onset refractory status epilepticus), 4 out of 36 (11%) anti NMDA-R encephalitis or anoxic ischemic aetiology, 3 out of 36 (~8%) were intracranial haemorrhage, 2 out of 36 (~6%) viral encephalitis.…”

Section: Analysed Datamentioning

confidence: 99%

Ketogenic Diet Treatment for Status Epilepticus

Sandu¹

2019

FARMACIA

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The ketogenic diet (KD) is a high fat normoproteic, low carbohydrate diet considered in recent years as an alternative treatment option for patients with refractory status epilepticus (RSE) or super-refractory status epilepticus (SRSE), both, in children and adults. The aim of current research is to review and compare the efficacy of KD in children and adults with RSE and SRSE regardless of underlying aetiology. We performed a retrospective PubMed search between June 1997 until 30 th of October 2017 and selected all articles in which KD was used for the treatment of children and adults with status epilepticus refractory to standard therapy. 120 patients (adults and children) with RSE and SRSE were identified. An important proportion of patients (92/120 ~ 77%, 64 children and 28 adults) responded to KD therapy. In conclusion, KD is proving to be a valuable therapeutic option in the intensive care units for the treatment of RSE and SRSE in children and adults, available data showing efficacy mostly but not limited to (febrile infection related to encephalopathy in school aged children) FIRES in children and encephalitis in adults. Specific protocols and training should be made available in intensive care units in order to implement and manage KD in children and adults with status epilepticus who do not respond to standard therapeutic approaches. RezumatDieta cetogenă (DC) este o dietă bogată în grăsimi, normoproteică şi cu un conținut sărac de carbohidrați, considerată în ultimii ani drept o opțiune de tratament pentru pacienții cu status epilepticus refractar (RSE) sau super-refractar (SRSE), atât la copii, cât și la adulți. Scopul cercetării actuale este de a analiza datele existente în literatură şi de a compara eficienţa DC la copii și adulți cu RSE și SRSE, indiferent de etiologie. S-a efectuat o cercetare retrospectivă a bazei de date PubMed din iunie 1997 pînă la 30 octombrie 2017, fiind selectate toate articolele în care DC a fost utilizată pentru tratamentul copiilor și adulților cu status epilepticus refractar la terapia standard. Au fost identificați 120 de pacienți (adulți și copii) cu RSE și SRSE. O proporție importantă de pacienți (92/120 ~ 77%, 64 copii și 28 adulți) au răspuns la terapia cu DC. În concluzie, DC se dovedește a fi o opțiune terapeutică valoroasă în unitățile de terapie intensivă pentru tratamentul statusului epileptic refractar şi superrefractar la copii și adulți, datele existente demonstrând eficienţa mai ales, dar nu exclusiv, în FIRES (febrile infection related encephalopathy in school-age children) la copii și encefalită la adulți. Protocoale specifice și instruire adecvată ar trebui să fie puse la dispoziție în unitățile de terapie intensivă pentru a implementa și administra DC la copiii și adulții cu status epilepticus care nu răspund la abordările terapeutice standard.

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Use of the ketogenic diet in an adult with myoclonic status epilepticus

Cited by 3 publications

References 0 publications

Systematic review of ketogenic diet use in adult patients with status epilepticus

Ketogenic Diet Treatment for Status Epilepticus

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