ABSTRACT
La dieta cetogénica se considera un tratamiento eficaz y bien tolerado para la epilepsia refractaria. Nuestro trabajo suministra información práctica sobre el uso de la dieta cetogénica, realizando una revisión acerca de las indicaciones clásicas y las nuevas que permiten ampliar el uso de la misma. Detallamos cómo implementar la dieta, los controles médicos en el seguimiento y la forma de actuar en situaciones especiales, tales como la anestesia o la enfermedad aguda. Se enfatiza la i mportancia del trabajo de los profesionales de las distintas especialidades y la familia como equipo, detallando los roles que ocupa cada uno en este interesante pero laborioso tratamiento.
The ketogenic diet is an established, effective and well-tolerated treatment in refractory epilepsy. This paper provides practical information on the administration of ketogenic diet. It goes over the standardized protocols and the new ones that allow to broaden the scope regarding the clinical management of the ketogenic diet. It addresses issues such as the implementation, counseling and follow-up as well as the application and how to proceed in special situations such as anesthesia or acute illness. Finally, the aim of this paper is to highlight the relevance of the multidisciplinary teamwork and the family support throughout this laborious but interesting treatment.
Subject(s)
Humans , Diet, Ketogenic/classification , Diet, Ketogenic/adverse effects , Drug Resistant Epilepsy/diet therapy , Drug Resistant Epilepsy/therapy , Interdisciplinary Studies , Diet, High-Protein Low-CarbohydrateABSTRACT
La dieta de Atkins modificada (DAM) es una alternativa dietaria terapéutica en el tratamiento de la epilepsia fármaco-resistente. Consiste en una dieta con un aporte de 60% de grasas, 30% de proteínas y 10% de carbohidratos. El objetivo es presentar una serie de 9 pacientes con diagnóstico de epilepsia refractaria de diferentes etiologías, que recibieron tratamiento con DAM en nuestro hospital. En nuestro grupo de 9 pacientes, obtuvimos resultados similares a los publicados por otros autores, con buena adherencia, tolerancia y respuesta. Del total de pacientes, dos lograron una reducción en más del 90% del número de crisis; cuatro, del 50-90%; dos, menos del 50% de control; y solo uno no presentó respuesta a la DAM. Ningún paciente presentó aumento del número de crisis, y fue bien tolerada en todos los casos
The modified Atkins diet (MAD) is an alternative therapeutic diet for the treatment of drug-resistant epilepsy. It consists of a diet with 60% energy from fat, 30% from protein, and 10% from carbohydrates. The objective of this article is to present a series of nine patients diagnosed with refractory epilepsy of different etiologies treated with the MAD at our hospital. In our group of nine patients, results obtained were similar to those published by other authors, with adequate adherence, tolerance and response. Of all patients, two achieved a reduction of more than 90% in the number of seizures; four experienced a reduction of 50-90%; two had a reduction of less than 50% in seizure control; and only one patient did not respond to the MAD. No patient had an increase in the number of seizures, and the diet was well-tolerated in all cases.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Young Adult , Diet, Carbohydrate-Restricted , Drug Resistant Epilepsy/drug therapyABSTRACT
INTRODUÇÃO: A dieta cetogênica (DC) e a dieta de Atkins modificada (DAM) são dietas terapêuticas mundialmente utilizadas no tratamento da epilepsia refratária em crianças e adultos. No Brasil estas modalidades de tratamento são pouco indicadas, restringindo a poucos centros. METODOLOGIA: Revisão de literatura sobre a utilização da DC e DAM no tratamento da epilepsia refratária. CONCLUSÕES: A DC e a DAM são opções terapêuticas eficazes e seguras no tratamento da epilepsia refratária. O acompanhamento destes pacientes deve ser rigoroso, com equipe treinada, prevendo os riscos potenciais e realizando dietas palatáveis e diversificadas.
INTRODUCTION: Ketogenic Diet (KD) and Modified Atkins Diet (MAD) are world-widely therapeutic diets used in the treatment of intractable epilepsy in children and adults. In Brazil those therapies are few indicated and restricted for some centers. METHODS: Revision of literature for the application of KD and MAD in the treatment of intractable epilepsy. CONCLUSIONS: KD and MAD are effective and secure in the treatment of intractable epilepsy. The follow up of these patients must be rigorous, with a trained staff to anticipate the potential risks and elaborating diversified and palatable diets.