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[生酮饮食对31例药物难治性癫痫性脑病患儿临床疗效及脑电图特征的影响]

[Influence of ketogenic diet on the clinical effects and electroencephalogram features in 31 children with pharmacoresistant epileptic encephalopathy].

作者信息

Li Bao-Min, Tong Li-Li, Jia Gui-Juan, Wang Ji-Wen, Lei Ge-Fei, Yin Ping, Sun Ruo-Peng

机构信息

Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China.

出版信息

Zhonghua Er Ke Za Zhi. 2013 May;51(5):362-6.

Abstract

OBJECTIVE

To investigate the effect of ketogenic diet (KD) on the clinical and electroencephalogram features in children with pharmacoresistant epileptic encephalopathy.

METHOD

Thirty-one children (19 boys, 12 girls) aged 7 months to 7 years (mean 2 years 5 month) with epilepsy refractory to conventional antiepileptic drugs (AEDs) were included in this study. In addition to their original AED treatment, the children were assigned to different ketogenic diets based on their age. The prospective electro-clinical assessment was performed prior to the KD and then one week, one month and again 3 months after the initiation of therapy, respectively.

RESULT

The reduction of seizure frequency in 52%, 68% and 71% of all patients exceeded 50% one week, one month and three months after KD treatment respectively. KD is particularly effective in myoclonic astatic epilepsy (MAE; Doose Syndrome) and West syndrome with 100% and 81.25% of the patients having a greater than 50% seizure reduction, respectively. After 3 months of KD treatment, more than 2/3 patients experienced a reduction in interictal epileptiform discharges (IEDs) and improvement in EEG background.

CONCLUSION

The clinical and electroencephalographic improvement confirms that KD is beneficial in children with refractory epilepsy.

摘要

目的

探讨生酮饮食(KD)对药物难治性癫痫性脑病患儿临床及脑电图特征的影响。

方法

本研究纳入31例年龄在7个月至7岁(平均2岁5个月)、对传统抗癫痫药物(AEDs)难治的癫痫患儿(19例男孩,12例女孩)。除原有的AED治疗外,根据年龄将患儿分配至不同的生酮饮食方案。在开始KD治疗前、治疗1周、1个月及3个月后分别进行前瞻性的电临床评估。

结果

KD治疗1周、1个月及3个月后,分别有52%、68%及71%的患者癫痫发作频率降低超过50%。KD对肌阵挛失张力癫痫(MAE;Doose综合征)和West综合征特别有效,分别有100%和81.25%的患者癫痫发作减少超过50%。KD治疗3个月后,超过2/3的患者发作间期癫痫样放电(IEDs)减少,脑电图背景改善。

结论

临床及脑电图的改善证实KD对难治性癫痫患儿有益。

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