Department of Neurology, The Johns Hopkins University, Baltimore, MD 21287, USA.
Biomed J. 2013 Jan-Feb;36(1):2-8. doi: 10.4103/2319-4170.107152.
Since their introduction in 1921, high-fat, low-carbohydrate "ketogenic" diets have been used worldwide for refractory childhood epilepsy. Approximately half of the children have at least half their seizures reduced, including 15% who are seizure free. The mechanisms of action of dietary therapies are under active investigation and appear to involve mitochondria. Once perceived as a last resort, modifications to initiation and maintenance, as well as the widespread use of pre-made ketogenic formulas have allowed dietary treatment to be used earlier in the course of epilepsy. For infantile spasms (West syndrome) specifically, the ketogenic diet is successful about 50% of the time as a first-line treatment. New "alternative" diets such as the modified Atkins diet were created in 2003 and can be started more easily and are less restrictive. They may have particular value for countries in Asia. Side effects include constipation, dyslipidemia, growth slowing, acidosis, and kidney stones. Additionally, neurologists are studying ketogenic diets for conditions other than epilepsy, including Alzheimer's disease, autism, and brain tumors.
自 1921 年问世以来，高脂肪、低碳水化合物的“生酮”饮食已在全球范围内用于治疗难治性儿童癫痫。大约一半的儿童至少有一半的癫痫发作减少，其中 15%的儿童癫痫发作完全停止。饮食疗法的作用机制正在积极研究中，似乎涉及线粒体。曾经被认为是最后的手段，对起始和维持的修改，以及广泛使用预制的生酮配方，使得饮食治疗可以在癫痫病程的早期使用。具体来说，对于婴儿痉挛（West 综合征），生酮饮食作为一线治疗的成功率约为 50%。新的“替代”饮食，如改良后的阿特金斯饮食，于 2003 年创建，可以更容易地开始，限制也更少。它们对亚洲国家可能具有特殊价值。副作用包括便秘、血脂异常、生长缓慢、酸中毒和肾结石。此外，神经病学家正在研究生酮饮食治疗除癫痫以外的疾病，包括阿尔茨海默病、自闭症和脑肿瘤。
