Li Baomin, Tong Lili, Jia Guijuan, Sun Ruopeng
Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China.
Exp Ther Med. 2013 Feb;5(2):611-615. doi: 10.3892/etm.2012.823. Epub 2012 Nov 22.
The aim of this study was to investigate the effects of a ketogenic diet (KD) on the clinical and electroencephalographic (EEG) features of children with drug therapy-resistant epilepsy. A total of 31 children with drug therapy-resistant epilepsy were selected, including 19 males and 12 females. The youngest was 7 months old and the oldest was 7 years old. Clinical seizures in the children prior to and 1 week, 1 month and 3 months after the initiation of the KD were compared and the clinical effect of the KD was evaluated. The ratio of fat to carbohydrate + protein in the KD was 4:1. Following the initiation of the KD treatment, the original antiepileptic drugs were not changed. The changes in occipital region background rhythm and interictal spike wave discharge index (SI) were evaluated prior to and 1 week, 1 month and 3 months after the initiation of the KD. The efficacy had an upward trend over time, with a total efficacy rate of 51.61% 1 week later, 67.74% 1 month later and 70.97% 3 months later. Doose syndrome showed the greatest response to KD, with a 100% efficacy rate. However, since there were only two cases in the study, its efficacy remains to be assessed. Infantile spasm also showed a good response to KD; 9 of the 16 patients were seizure free and the total efficacy rate was 81.25%. As the length of the KD treatment was increased, the background rhythms of the children underwent significant changes and the SI was significantly reduced. KD not only demonstrated good clinical efficacy, but also significantly reduced the frequency of interictal epileptic discharges and improved the EEG background rhythm.
本研究旨在探讨生酮饮食（KD）对药物治疗难治性癫痫患儿临床及脑电图（EEG）特征的影响。共选取31例药物治疗难治性癫痫患儿，其中男性19例，女性12例。年龄最小7个月，最大7岁。比较患儿在开始KD治疗前及治疗后1周、1个月和3个月的临床发作情况，并评估KD的临床疗效。KD中脂肪与碳水化合物+蛋白质的比例为4:1。开始KD治疗后，原抗癫痫药物不变。在开始KD治疗前及治疗后1周、1个月和3个月评估枕区背景节律及发作间期棘波放电指数（SI）的变化。疗效随时间呈上升趋势，1周后总有效率为51.61%，1个月后为67.74%，3个月后为70.97%。杜斯综合征对KD反应最大，有效率为100%。然而，由于本研究中仅有2例，其疗效仍有待评估。婴儿痉挛症对KD也有良好反应；16例患者中有9例无发作，总有效率为81.25%。随着KD治疗时间的延长，患儿的背景节律发生显著变化，SI显著降低。KD不仅显示出良好的临床疗效，还显著降低了发作间期癫痫放电频率，改善了EEG背景节律。
