Kossoff Eric H, Nabbout Rima
John M. Freeman Pediatric Epilepsy Center, Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
J Child Neurol. 2013 Aug;28(8):1049-51. doi: 10.1177/0883073813487601. Epub 2013 May 1.
One of the newest and yet fastest growing indications for dietary therapy is the emergency treatment of refractory status epilepticus. Ten retrospective publications since 2008 have reported benefits in 32 children and adults, of whom 25 (78%) became seizure-free. Most of the patients who responded did so within 7 to 10 days of the initiation of nasogastrically administered ketogenic formulas. Encephalitis and febrile-illness related epilepsy syndrome causing status epilepticus highly refractory to antiepileptic drugs may be particularly amenable to dietary treatment. Prospective, multicenter studies are under way to help clarify who best will respond, how quickly, and the optimal diet duration after success.
饮食疗法最新且增长迅速的适应症之一是难治性癫痫持续状态的紧急治疗。自2008年以来的十篇回顾性出版物报道了32名儿童和成人从中受益,其中25人(78%)癫痫发作停止。大多数有反应的患者在开始经鼻饲管给予生酮配方饮食后的7至10天内出现反应。由脑炎和发热性疾病相关癫痫综合征引起的对抗癫痫药物高度难治的癫痫持续状态可能特别适合饮食治疗。正在进行前瞻性多中心研究,以帮助明确谁最有可能产生反应、反应有多快以及成功后的最佳饮食持续时间。