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高脂饮食与肌阵挛-失张力癫痫的癫痫控制:单中心经验

High-fat diets and seizure control in myoclonic-astatic epilepsy: a single center's experience.

作者信息

Simard-Tremblay Elisabeth, Berry Patricia, Owens Aaron, Cook William Byron, Sittner Haley R, Mazzanti Marta, Huber Jennifer, Warner Molly, Shurtleff Hillary, Saneto Russell P

机构信息

Division Pediatric Neurology, Seattle Children's Hospital/University of Washington, Seattle, WA, USA.

Division of Nutrition, Seattle Children's Hospital, Seattle, WA, USA.

出版信息

Seizure. 2015 Feb;25:184-6. doi: 10.1016/j.seizure.2014.10.009. Epub 2014 Oct 23.

Abstract

PURPOSE

To determine the efficacy of the Modified Atkins Diet (MAD) and Ketogenic Diet (KD) in seizure control within a population of myoclonic-astatic epilepsy (MAE) patients.

METHODS

This was a retrospective, single center study evaluating the seizure control by high fat diets. Seizure diaries kept by the parents performed seizure counts. All patients met the clinical criteria for MAE.

RESULTS

Nine patients met the clinical criteria. We found that both the MAD and KD were efficacious in complete seizure control and allowed other medications to be stopped in seven patients. Two patients had greater than 90% seizure control without medications, one on the KD and the other on the MAD. Seizure freedom has ranged from 13 to 36 months, and during this time four patients have been fully weaned off of diet management. One patient was found to have a mutation in SLC2A1.

CONCLUSION

Our results suggest that strictly defined MAE patients respond to the MAD with prolonged seizure control. Some patients may require the KD for seizure freedom, suggesting a common pathway of increased requirement for fats. Once controlled, those fully responsive to the Diet(s) could be weaned off traditional seizure medications and in many, subsequently off the MAD or KD.

摘要

目的

确定改良阿特金斯饮食(MAD)和生酮饮食(KD)在肌阵挛-失张力癫痫(MAE)患者群体中控制癫痫发作的疗效。

方法

这是一项回顾性单中心研究,评估高脂肪饮食对癫痫发作的控制情况。由家长记录的癫痫发作日记进行癫痫发作计数。所有患者均符合MAE的临床标准。

结果

9名患者符合临床标准。我们发现MAD和KD在完全控制癫痫发作方面均有效,7名患者能够停用其他药物。两名患者在未使用药物的情况下癫痫发作控制率超过90%,一名采用KD,另一名采用MAD。癫痫发作缓解期为13至36个月,在此期间,4名患者已完全停止饮食管理。发现一名患者SLC2A1存在突变。

结论

我们的结果表明,严格定义的MAE患者对MAD有反应,癫痫发作得到长期控制。一些患者可能需要KD来实现癫痫发作缓解,这表明存在对脂肪需求增加的共同途径。一旦得到控制,那些对饮食完全有反应的患者可以停用传统抗癫痫药物,并且在许多情况下,随后停用MAD或KD。

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