Ito Susumu, Oguni Hirokazu, Ito Yasushi, Ishigaki Keiko, Ohinata Junko, Osawa Makiko
Department of Pediatrics, Tokyo Women's Medical University, 8-1, Tokyo 162-8666, Japan.
Brain Dev. 2008 Mar;30(3):226-8. doi: 10.1016/j.braindev.2007.08.006. Epub 2007 Sep 14.
Glucose transporter type 1 deficiency syndrome (GLUT-1 DS), giving rise to impaired glucose transport across the blood-brain barrier, is characterized by infantile seizures, complex motor disorders, global developmental delay, acquired microcephaly, and hypoglycorrhachia. GLUT-1 DS can be treated effectively with a ketogenic diet because it can provide an alternative fuel for brain metabolism; however, the excessive restriction of food intake involved frequently makes it difficult for patients to initiate or continue the diet. Recently, the modified Atkins diet, which is much less restrictive in terms of the total calorie and protein intake than the classical ketogenic diet, has been shown to be effective and well tolerated in children with intractable epilepsy. We successfully introduced the modified Atkins diet to a 7-year-old boy with GLUT-1 DS, whose caregivers refused ketogenic diet treatment because of strong concerns over restricting the diet. The modified Atkins diet should be considered for patients with GLUT-1 DS as an alternative to the traditional ketogenic diet.
1型葡萄糖转运体缺乏综合征(GLUT-1 DS)导致葡萄糖跨血脑屏障转运受损,其特征为婴儿期癫痫发作、复杂运动障碍、全面发育迟缓、后天性小头畸形和脑脊液低糖。GLUT-1 DS可通过生酮饮食有效治疗,因为它可为脑代谢提供替代燃料;然而,频繁涉及的食物摄入过度限制常常使患者难以开始或持续这种饮食。最近,改良阿特金斯饮食在总热量和蛋白质摄入方面比经典生酮饮食限制少得多,已被证明对难治性癫痫患儿有效且耐受性良好。我们成功地将改良阿特金斯饮食引入一名7岁的GLUT-1 DS男孩,其照顾者因强烈担心饮食限制而拒绝生酮饮食治疗。对于GLUT-1 DS患者,应考虑采用改良阿特金斯饮食作为传统生酮饮食的替代方案。