Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184 |
Resumo: | Introduction: Ketogenic diet is a low carbohydrate diet, which can be used as a treatment for refractory childhood epilepsy. The first aim of this study was to evaluate its efficacy, in patients receiving ketogenic diet for at least three months, on epilepsy control, behaviour and awareness. The secondary aims were to evaluate the variation in the number of antiepileptic drugs, reasons for discontinuing the diet and adverse effects.Material and Methods: Retrospective analysis of clinical records of patients who underwent ketogenic diet for refractory epilepsy, from October 2007 to January 2018, in a tertiary pediatric hospital.Results: In the twenty-nine eligible patients, the mean age of initiation was 7.9 years-old (+/– 5.6). Of those, 18 had a ≥ 50% reduction of seizure activity, 19 a marked behaviour improvement and 18 improved awareness. The median number of antiepileptic drugs remained equal for the 15 patients who completed 18 months of treatment (three drugs). The main reason for discontinuing ketogenic diet was a familiar decision. The main adverse effects were hypercholesterolemia (n = 23) and hypertriglyceridemia (n = 21).Discussion: Results were comparable to those of other cohorts, namely age of initiation, proportion of patients completing ketogenic diet, most frequent reasons for stopping and significant improvement of alertness and behavior.Conclusion: Beyond seizure control, patients experienced a marked improvement in behavior and awareness. It is necessary to develop strategies to increase the adherence of families to the diet. |
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Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric CentreDieta Cetogénica na Epilepsia Infantil Refratária: Para além do Controlo das Crises, Experiência de um Centro Pediátrico PortuguêsChildDietKetogenicDrug Resistant Epilepsy/diet therapyPortugalCriançaEpilepsia Resistente a Medicamentos/dietoterapiaPortugalIntroduction: Ketogenic diet is a low carbohydrate diet, which can be used as a treatment for refractory childhood epilepsy. The first aim of this study was to evaluate its efficacy, in patients receiving ketogenic diet for at least three months, on epilepsy control, behaviour and awareness. The secondary aims were to evaluate the variation in the number of antiepileptic drugs, reasons for discontinuing the diet and adverse effects.Material and Methods: Retrospective analysis of clinical records of patients who underwent ketogenic diet for refractory epilepsy, from October 2007 to January 2018, in a tertiary pediatric hospital.Results: In the twenty-nine eligible patients, the mean age of initiation was 7.9 years-old (+/– 5.6). Of those, 18 had a ≥ 50% reduction of seizure activity, 19 a marked behaviour improvement and 18 improved awareness. The median number of antiepileptic drugs remained equal for the 15 patients who completed 18 months of treatment (three drugs). The main reason for discontinuing ketogenic diet was a familiar decision. The main adverse effects were hypercholesterolemia (n = 23) and hypertriglyceridemia (n = 21).Discussion: Results were comparable to those of other cohorts, namely age of initiation, proportion of patients completing ketogenic diet, most frequent reasons for stopping and significant improvement of alertness and behavior.Conclusion: Beyond seizure control, patients experienced a marked improvement in behavior and awareness. It is necessary to develop strategies to increase the adherence of families to the diet.Introdução: A dieta cetogénica é uma dieta com baixo teor de hidratos de carbono, que pode ser usada no tratamento da epilepsia infantil refratária. O principal objetivo deste estudo foi avaliar a eficácia nos doentes que completaram pelo menos três meses de dieta, no que respeita ao controlo das crises, comportamento e estado de alerta. Foi também avaliada a variação do número de fármacos antiepiléticos, as razões de descontinuação e os efeitos secundários.Material e Métodos: Análise retrospetiva dos processos clínicos dos doentes com epilepsia refratária sob dieta cetogénica, de outubro de 2007 a janeiro de 2018, num hospital pediátrico de nível 3. Resultados: Nos 29 doentes elegíveis, a média da idade de implementação foi 7,9 anos (+/– 5,6). Destes, 18 tiveram uma redução ≥ 50% das crises, 19 tiveram uma melhoria marcada do comportamento e 18 do seu estado de alerta. Dos 15 que completaram 18 meses, a mediana do número de fármacos antiepiléticos permaneceu idêntica à do início (três fármacos). A principal razão de descontinuação foi por decisão familiar. Os principais efeitos secundários foram a hipercolesterolémia (n = 23) e a hipertrigliceridémia(n = 21).Discussão: Os resultados foram semelhantes aos obtidos noutras coortes, nomeadamente no que respeita à idade de início, à percentagem de doentes que completou a dieta, às razões da suspensão e à melhoria do comportamento e estado de alerta.Conclusão: Para além do controlo das crises, os doentes tiveram uma marcada melhoria do seu comportamento e estado de alerta. É necessário desenvolver estratégias para aumentar a adesão das famílias à dieta.Ordem dos Médicos2019-12-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184oai:ojs.www.actamedicaportuguesa.com:article/12184Acta Médica Portuguesa; Vol. 32 No. 12 (2019): December; 760-766Acta Médica Portuguesa; Vol. 32 N.º 12 (2019): Dezembro; 760-7661646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/5810https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11329https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11330https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11331https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11332https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11333https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11334https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11551Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessRomão Luz, InêsPereira, CristinaGarcia, PaulaFerreira, FátimaFaria, AnaMacedo, CristianeDiogo, LuísaRobalo, Conceição2022-12-20T11:06:32Zoai:ojs.www.actamedicaportuguesa.com:article/12184Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:09.349706Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre Dieta Cetogénica na Epilepsia Infantil Refratária: Para além do Controlo das Crises, Experiência de um Centro Pediátrico Português |
title |
Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre |
spellingShingle |
Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre Romão Luz, Inês Child Diet Ketogenic Drug Resistant Epilepsy/diet therapy Portugal Criança Epilepsia Resistente a Medicamentos/dietoterapia Portugal |
title_short |
Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre |
title_full |
Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre |
title_fullStr |
Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre |
title_full_unstemmed |
Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre |
title_sort |
Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre |
author |
Romão Luz, Inês |
author_facet |
Romão Luz, Inês Pereira, Cristina Garcia, Paula Ferreira, Fátima Faria, Ana Macedo, Cristiane Diogo, Luísa Robalo, Conceição |
author_role |
author |
author2 |
Pereira, Cristina Garcia, Paula Ferreira, Fátima Faria, Ana Macedo, Cristiane Diogo, Luísa Robalo, Conceição |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Romão Luz, Inês Pereira, Cristina Garcia, Paula Ferreira, Fátima Faria, Ana Macedo, Cristiane Diogo, Luísa Robalo, Conceição |
dc.subject.por.fl_str_mv |
Child Diet Ketogenic Drug Resistant Epilepsy/diet therapy Portugal Criança Epilepsia Resistente a Medicamentos/dietoterapia Portugal |
topic |
Child Diet Ketogenic Drug Resistant Epilepsy/diet therapy Portugal Criança Epilepsia Resistente a Medicamentos/dietoterapia Portugal |
description |
Introduction: Ketogenic diet is a low carbohydrate diet, which can be used as a treatment for refractory childhood epilepsy. The first aim of this study was to evaluate its efficacy, in patients receiving ketogenic diet for at least three months, on epilepsy control, behaviour and awareness. The secondary aims were to evaluate the variation in the number of antiepileptic drugs, reasons for discontinuing the diet and adverse effects.Material and Methods: Retrospective analysis of clinical records of patients who underwent ketogenic diet for refractory epilepsy, from October 2007 to January 2018, in a tertiary pediatric hospital.Results: In the twenty-nine eligible patients, the mean age of initiation was 7.9 years-old (+/– 5.6). Of those, 18 had a ≥ 50% reduction of seizure activity, 19 a marked behaviour improvement and 18 improved awareness. The median number of antiepileptic drugs remained equal for the 15 patients who completed 18 months of treatment (three drugs). The main reason for discontinuing ketogenic diet was a familiar decision. The main adverse effects were hypercholesterolemia (n = 23) and hypertriglyceridemia (n = 21).Discussion: Results were comparable to those of other cohorts, namely age of initiation, proportion of patients completing ketogenic diet, most frequent reasons for stopping and significant improvement of alertness and behavior.Conclusion: Beyond seizure control, patients experienced a marked improvement in behavior and awareness. It is necessary to develop strategies to increase the adherence of families to the diet. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-12-02 |
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info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184 oai:ojs.www.actamedicaportuguesa.com:article/12184 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184 |
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oai:ojs.www.actamedicaportuguesa.com:article/12184 |
dc.language.iso.fl_str_mv |
eng |
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eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/5810 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11329 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11330 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11331 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11332 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11333 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11334 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12184/11551 |
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Direitos de Autor (c) 2019 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2019 Acta Médica Portuguesa |
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openAccess |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 32 No. 12 (2019): December; 760-766 Acta Médica Portuguesa; Vol. 32 N.º 12 (2019): Dezembro; 760-766 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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