RESUMO
Ketogenic diet (KD) has been applied to the treatment of epilepsy for the last century, although it has been underestimated due to the complicated preparation for beginners and the emergence of antiepileptic drugs.Due to the limitations of the mechanism of drug treatment of epilepsy, and the pathogenesis of epilepsy is complex, the incidence of drug-resistant epilepsy has not improved with the development of drugs over the years.KD plays an anti-epileptic and neuroprotective role through a variety of mechanisms, which is also effective to refractory epilepsy.As a result, KD has been emphasized again.Classical KD has high fat content and complicated operation.When the training is not fine enough, many patients cannot understand and qualify the operation.To overcome the disadvantages of the conventional KD, a modified KD has been developed that is closer to a normal diet structure and has a good tolerance, namely the low glycemic index treatment (LGIT). LGIT is featured by a slightly higher intake of carbohydrates, simplified meal preparation, improved taste and tolerance.This review aims to describe the mechanism, clinical outcomes and indications of LGIT in children with refractory epilepsy.
RESUMO
A ketogenic diet (KD) is a dietary approach to treat intractable epilepsy. The KD begins with hospitalization and the child and their parents can adapt to the KD for 1-2 weeks. Recently, various type of dietary intervention such as the modified Atkins diet (MAD) and the low glycemic index treatment (LGIT) have been performed. Since 2010, we carried out the KD, MAD, and LGIT for total of 802 patients; 489 patients (61%) for the KD, 147 patients (18.3%) with the MAD, and 166 patients (20.7%) for the LGIT. In this report, application of these dietary practices in Severance Hospital is shared.
Assuntos
Criança , Humanos , Dieta com Restrição de Carboidratos , Epilepsia , Índice Glicêmico , Hospitalização , Dieta Cetogênica , Refeições , PaisRESUMO
Objective To simplify the manipulation of ketogenic diet recipes through software design.Methods Based on a Chinese food composition database,the software included 3 separate modules for the calculation of recipes for the classic ketogenic diet,modified Atkins diet and low glycemic index diet.It was applied in 10 refractory epilepsy patients,including 8 children and 2 adults,aged from 1 to 34 years,who took an average of 2.7 kinds of medication.Eight patients had daily seizures ;the other 2 cases had seizures 4-15 times per month.Two patients used the classic 4 ∶ 1 ketogenic diet module;4 patients started with the classic 4 ∶ 1 ketogenic diet and then shifted to 1 ∶ 1 to 4 ∶1 modified Atkins diet module after 2 to 5 months;4 patients used the 1 ∶ 1 to 4 ∶ 1 modified Atkins diet module.The software could automatically display the daily recommended intake value of total energy,fat,carbohydrate and protein according to the input of age,height,weight,activity level and the proportion of fat/(carbohydrate and protein),then patients or dietitians were allowed to select a different modules for recipe design.Results Forty percents(4/10 cases) of the patients had seizure reduced to 50％-90％,20％ (2/10 cases) of the patients had seizure reduced to 90％ 99％,and 20％ (2/10 cases) of the patients became seizure free.Half-year retention rate reached 70％ (7/10 cases).Conclusions This specially designed software for Chinese epilepsy patients can help simplify the operation of the ketogenic diet and modified Atkins diet and improve retention rates.It can be used in classic and non-classical ketogenic diets.