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Impact of two ketogenic diet types in refractory childhood epilepsy

BACKGROUND: Ketogenic diet (KD) refers to any diet in which food composition induces a ketogenic state of human metabolism. OBJECTIVE: To assess short- and long-term efficacy, safety, and tolerability of KD [classic KD and modified Atkins diet (MAD)] in childhood drug-resistant epilepsy (DRE) and to...

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Autores principales: El-Shafie, Ali M., Bahbah, Wael A., Abd El Naby, Sameh A., Omar, Zein A., Basma, Elsayedamr M., Hegazy, Aya A. A., El Zefzaf, Heba M. S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group US 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10007663/
https://www.ncbi.nlm.nih.gov/pubmed/36906721
http://dx.doi.org/10.1038/s41390-023-02554-w
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author El-Shafie, Ali M.
Bahbah, Wael A.
Abd El Naby, Sameh A.
Omar, Zein A.
Basma, Elsayedamr M.
Hegazy, Aya A. A.
El Zefzaf, Heba M. S.
author_facet El-Shafie, Ali M.
Bahbah, Wael A.
Abd El Naby, Sameh A.
Omar, Zein A.
Basma, Elsayedamr M.
Hegazy, Aya A. A.
El Zefzaf, Heba M. S.
author_sort El-Shafie, Ali M.
collection PubMed
description BACKGROUND: Ketogenic diet (KD) refers to any diet in which food composition induces a ketogenic state of human metabolism. OBJECTIVE: To assess short- and long-term efficacy, safety, and tolerability of KD [classic KD and modified Atkins diet (MAD)] in childhood drug-resistant epilepsy (DRE) and to investigate the effect of KD on electroencephalographic (EEG) features of children with DRE. METHODS: Forty patients diagnosed with DRE according to International League Against Epilepsy were included and randomly assigned into classic KD or MAD groups. KD was initiated after clinical, lipid profile and EEG documentation, and regular follow-up was done for 24 months. RESULTS: Out of 40 patients with DRE, 30 completed this study. Both classic KD and MAD were effective in seizure control as 60% in classic KD group and 53.33% in MAD group became seizure free, and the remaining showed ≥50% seizure reduction. Lipid profile remained within acceptable levels throughout the study period in both groups. Adverse effects were mild and managed medically with an improvement of growth parameters and EEG during the study period. CONCLUSIONS: KD is an effective and safe non-pharmacologic, non-surgical therapy for the management of DRE with a positive impact on growth and EEG. IMPACT: Both common types of KD (classic KD and MAD) are effective for DRE, but unfortunately, nonadherence and dropout rates are frequent. High serum lipid profile (cardiovascular AE) is often suspected in children following a high-fat diet, but lipid profile remained in the acceptable level up to 24 months. Therefore, KD constitutes a safe treatment. KD had a positive impact on growth, despite inconsistent results of the KD’s effect on growth. In addition to showing strong clinical effectiveness, KD also considerably decreased the frequency of interictal epileptiform discharges and enhanced the EEG background rhythm.
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spelling pubmed-100076632023-03-11 Impact of two ketogenic diet types in refractory childhood epilepsy El-Shafie, Ali M. Bahbah, Wael A. Abd El Naby, Sameh A. Omar, Zein A. Basma, Elsayedamr M. Hegazy, Aya A. A. El Zefzaf, Heba M. S. Pediatr Res Clinical Research Article BACKGROUND: Ketogenic diet (KD) refers to any diet in which food composition induces a ketogenic state of human metabolism. OBJECTIVE: To assess short- and long-term efficacy, safety, and tolerability of KD [classic KD and modified Atkins diet (MAD)] in childhood drug-resistant epilepsy (DRE) and to investigate the effect of KD on electroencephalographic (EEG) features of children with DRE. METHODS: Forty patients diagnosed with DRE according to International League Against Epilepsy were included and randomly assigned into classic KD or MAD groups. KD was initiated after clinical, lipid profile and EEG documentation, and regular follow-up was done for 24 months. RESULTS: Out of 40 patients with DRE, 30 completed this study. Both classic KD and MAD were effective in seizure control as 60% in classic KD group and 53.33% in MAD group became seizure free, and the remaining showed ≥50% seizure reduction. Lipid profile remained within acceptable levels throughout the study period in both groups. Adverse effects were mild and managed medically with an improvement of growth parameters and EEG during the study period. CONCLUSIONS: KD is an effective and safe non-pharmacologic, non-surgical therapy for the management of DRE with a positive impact on growth and EEG. IMPACT: Both common types of KD (classic KD and MAD) are effective for DRE, but unfortunately, nonadherence and dropout rates are frequent. High serum lipid profile (cardiovascular AE) is often suspected in children following a high-fat diet, but lipid profile remained in the acceptable level up to 24 months. Therefore, KD constitutes a safe treatment. KD had a positive impact on growth, despite inconsistent results of the KD’s effect on growth. In addition to showing strong clinical effectiveness, KD also considerably decreased the frequency of interictal epileptiform discharges and enhanced the EEG background rhythm. Nature Publishing Group US 2023-03-11 2023 /pmc/articles/PMC10007663/ /pubmed/36906721 http://dx.doi.org/10.1038/s41390-023-02554-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Clinical Research Article
El-Shafie, Ali M.
Bahbah, Wael A.
Abd El Naby, Sameh A.
Omar, Zein A.
Basma, Elsayedamr M.
Hegazy, Aya A. A.
El Zefzaf, Heba M. S.
Impact of two ketogenic diet types in refractory childhood epilepsy
title Impact of two ketogenic diet types in refractory childhood epilepsy
title_full Impact of two ketogenic diet types in refractory childhood epilepsy
title_fullStr Impact of two ketogenic diet types in refractory childhood epilepsy
title_full_unstemmed Impact of two ketogenic diet types in refractory childhood epilepsy
title_short Impact of two ketogenic diet types in refractory childhood epilepsy
title_sort impact of two ketogenic diet types in refractory childhood epilepsy
topic Clinical Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10007663/
https://www.ncbi.nlm.nih.gov/pubmed/36906721
http://dx.doi.org/10.1038/s41390-023-02554-w
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