Modified ketogenic diets in adults with refractory epilepsy: Efficacious improvements in seizure frequency, seizure severity, and quality of life
Modified ketogenic diets in adults with refractory epilepsy: Efficacious improvements in seizure frequency, seizure severity, and quality of life
复制标题
DOI：
10.1016/j.yebeh.2018.12.010
复制
发表时间：
2019-04-01
影响因子：
2.6
通讯作者：
Balabanov, Antoaneta
中科院分区：
文献类型：
--
作者：
Roehl, Kelly;Falco-Walter, Jessica;Balabanov, Antoaneta
目的：本研究评估改良生酮饮食（MKD）对成人耐药癫痫（DRE）患者癫痫发作频率、严重程度和生活质量（QOL）的影响，以及MKD治疗的潜在并发症。方法：观察癫痫发作频率、严重程度的变化。对17岁、使用DRE（>= 2种抗癫痫药物（aed））的成人患者进行MKD治疗3个月后的生活质量和不良反应进行回顾性分析。注意药物或迷走神经刺激器（VNS）的变化以及评估潜在的混杂因素。结果：55例患者中有60% （n = 33）报告发作频率改善50%，42例（76%）报告发作严重程度改善，48例（87%）报告生活质量改善。改良生酮饮食（每日15克净碳水化合物（MKD-15））（95%）与MKD-50（69%）相比，更多的患者报告生活质量改善（p = 0.02）。整个样本的体重从77.5 (20)kg下降到73.9 (19.0)kg (p < 0.0001)，总胆固醇（TC）、低密度脂蛋白（LDL）和总胆固醇：高密度脂蛋白（TC:HDL）显著升高（p = 0.03、p = 0.04和p = 0.02）。在一些选定的患者中，有26例（47%）在基线时，7例（13%）在随访时，其中8例（31%）在基线时，2例（29%）在随访时存在camitine缺乏症(
Objective: This study evaluates the efficacy of a modified ketogenic diet (MKD) on seizure frequency, severity, and quality of life (QOL), as well as potential complications of MKD therapy among adults with drug-resistant epilepsy (DRE).Methods: Changes in seizure frequency, severity. QOL, and side effects were retrospectively examined among adults, >= 17 years of age, with DRE (>= 2 antiepileptic drugs (AEDs]), after 3 months of MKD therapy. Attention was paid to medication or vagus nerve stimulator (VNS) changes as well to evaluate potential confounders.Results: A total of 60% (n = 33) of the 55 individuals reported >= 50% seizure frequency improvement, 42 (76%) reported improvement in seizure severity, and 48 (87%) reported improvement in QOL. More patients following a modified ketogenic diet - 15 g net carbohydrate daily (MKD-15) (95%) compared with a MKD-50 (69%) reported improvement in QOL (p = 0.02). Weight among the entire sample declined from 77.5 (20) kg to 73.9 (19.0) kg (p < 0.0001), and total cholesterol (TC), low density lipoprotein (LDL), and total cholesterol:high density lipoprotein (TC:HDL) increased significantly (p = 0.03, p = 0.04, and p = 0.02, respectively). Free camitine values were available for a select number of patients, 26 (47%) at baseline, and 7 (13%) at follow-up, of which 8 (31%) at baseline, and 2 (29%) at follow-up had camitine deficiency (