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Systematic review of ketogenic diet use in adult patients with status epilepticus

Status epilepticus (SE) is a medical emergency that is associated with a significant morbidity and mortality. Recently, there has been significant interest in the use of ketogenic diets (KD) in the management of SE. KD is a high‐fat, low‐carbohydrate, and adequate protein diet that has been shown to...

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Autores principales: Mahmoud, Sherif Hanafy, Ho‐Huang, Ethos, Buhler, Jessica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049803/
https://www.ncbi.nlm.nih.gov/pubmed/32140640
http://dx.doi.org/10.1002/epi4.12370
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author Mahmoud, Sherif Hanafy
Ho‐Huang, Ethos
Buhler, Jessica
author_facet Mahmoud, Sherif Hanafy
Ho‐Huang, Ethos
Buhler, Jessica
author_sort Mahmoud, Sherif Hanafy
collection PubMed
description Status epilepticus (SE) is a medical emergency that is associated with a significant morbidity and mortality. Recently, there has been significant interest in the use of ketogenic diets (KD) in the management of SE. KD is a high‐fat, low‐carbohydrate, and adequate protein diet that has been shown to be a safe and effective adjuvant to present SE management in patients with refractory epilepsy. Many case reports and case series have demonstrated the potential safety and effectiveness of KD for the acute treatment of SE; however, quality studies remain scarce on this topic. The purpose of this systematic review is to summarize the available evidence for the safety and effectiveness of KD in adults with SE. A literature search was performed in MEDLINE, EMBASE, Cochrane Library, and CINAHL (September 14, 2018). The search was repeated on March 27, 2019, to include any studies published since the original search. Keywords related to KD and SE were used. Studies were selected based on the reported use of the KD in SE. The search resulted in a total of 954 records. After screening and full‐text review, 17 articles were included in this review: four observational studies, 10 case reports, and 3 case series. Based on the observational studies, a total of 38 Patients with SE have been reported. KD was successful in achieving cessation of SE in 31 Patients (82%). The most common adverse effects reported were metabolic acidosis, hyperlipidemia, and hypoglycemia. The current limited evidence suggests that KD might be considered as an option for adult patients with SE. Although promising, the results need to be interpreted with caution due to the inherent bias, confounding and small sample size of the included studies. A randomized controlled trial is recommended to establish role of KD in the management of SE in adults.
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spelling pubmed-70498032020-06-11 Systematic review of ketogenic diet use in adult patients with status epilepticus Mahmoud, Sherif Hanafy Ho‐Huang, Ethos Buhler, Jessica Epilepsia Open Critical Review Status epilepticus (SE) is a medical emergency that is associated with a significant morbidity and mortality. Recently, there has been significant interest in the use of ketogenic diets (KD) in the management of SE. KD is a high‐fat, low‐carbohydrate, and adequate protein diet that has been shown to be a safe and effective adjuvant to present SE management in patients with refractory epilepsy. Many case reports and case series have demonstrated the potential safety and effectiveness of KD for the acute treatment of SE; however, quality studies remain scarce on this topic. The purpose of this systematic review is to summarize the available evidence for the safety and effectiveness of KD in adults with SE. A literature search was performed in MEDLINE, EMBASE, Cochrane Library, and CINAHL (September 14, 2018). The search was repeated on March 27, 2019, to include any studies published since the original search. Keywords related to KD and SE were used. Studies were selected based on the reported use of the KD in SE. The search resulted in a total of 954 records. After screening and full‐text review, 17 articles were included in this review: four observational studies, 10 case reports, and 3 case series. Based on the observational studies, a total of 38 Patients with SE have been reported. KD was successful in achieving cessation of SE in 31 Patients (82%). The most common adverse effects reported were metabolic acidosis, hyperlipidemia, and hypoglycemia. The current limited evidence suggests that KD might be considered as an option for adult patients with SE. Although promising, the results need to be interpreted with caution due to the inherent bias, confounding and small sample size of the included studies. A randomized controlled trial is recommended to establish role of KD in the management of SE in adults. John Wiley and Sons Inc. 2019-11-24 /pmc/articles/PMC7049803/ /pubmed/32140640 http://dx.doi.org/10.1002/epi4.12370 Text en © 2019 The Authors. Epilepsia Open published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Critical Review
Mahmoud, Sherif Hanafy
Ho‐Huang, Ethos
Buhler, Jessica
Systematic review of ketogenic diet use in adult patients with status epilepticus
title Systematic review of ketogenic diet use in adult patients with status epilepticus
title_full Systematic review of ketogenic diet use in adult patients with status epilepticus
title_fullStr Systematic review of ketogenic diet use in adult patients with status epilepticus
title_full_unstemmed Systematic review of ketogenic diet use in adult patients with status epilepticus
title_short Systematic review of ketogenic diet use in adult patients with status epilepticus
title_sort systematic review of ketogenic diet use in adult patients with status epilepticus
topic Critical Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7049803/
https://www.ncbi.nlm.nih.gov/pubmed/32140640
http://dx.doi.org/10.1002/epi4.12370
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