Beniczky S, Jose Miranda M, Alving J, Heber Povlsen J, Wolf P
Danish Epilepsy Centre, Dianalund, Denmark.
Acta Neurol Scand. 2010 Jan;121(1):58-62. doi: 10.1111/j.1600-0404.2009.01303.x. Epub 2009 Nov 26.
Ketogenic diet (KD) is an effective treatment for pharmacoresistant epilepsy: more than half of the patients show a greater than 50% reduction in seizures.
To identify clinical or electroencephalogram (EEG) variables predicting the response to KD.
Clinical and EEG data were retrospectively analysed from 50 consecutive patients treated by KD for severe, pharmacoresistant epilepsy. Most of the patients (70%) had retarded mental and motor development.
Three months after the start of the KD two-thirds (33) of the patients were responders (had a more than 50% reduction in seizure frequency). The presence of epileptiform EEG discharges in the temporal region correlated with an unfavourable response (P = 0.03). The presence of bilateral synchronous epileptiform discharges, and the presence of complex partial seizures approached significance but all other variables did not.
Our results further support that KD is efficient in a wide variety of epileptic patients with a broad range of EEG features. However, patients with epileptiform discharges in the temporal region are less likely to achieve therapeutic response.
生酮饮食（KD）是治疗药物难治性癫痫的一种有效方法：超过半数的患者癫痫发作减少超过50%。
确定预测KD疗效的临床或脑电图（EEG）变量。
对50例接受KD治疗的严重药物难治性癫痫患者的临床和EEG数据进行回顾性分析。大多数患者（70%）存在智力和运动发育迟缓。
开始KD治疗三个月后，三分之二（33例）患者有反应（癫痫发作频率减少超过50%）。颞区存在癫痫样EEG放电与不良反应相关（P = 0.03）。双侧同步癫痫样放电的存在以及复杂部分性发作的存在接近显著水平，但所有其他变量均无此关联。
我们的结果进一步支持KD对具有广泛EEG特征的各种癫痫患者有效。然而，颞区有癫痫样放电的患者不太可能获得治疗反应。
