Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Pediatrics, The Johns Hopkins Hospital, Baltimore, MD, USA; Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD, USA.
Epilepsy Behav. 2019 Apr;93:29-31. doi: 10.1016/j.yebeh.2019.01.042. Epub 2019 Mar 1.
The ketogenic diet (KD) is often started not only for seizure reduction but also to potentially wean antiseizure drugs (ASDs) in children with epilepsy. Although there have been several publications regarding ASD reduction on the KD, it is unknown how often complete medication withdrawal occurs. We reviewed the charts of all children started on the KD at Johns Hopkins Hospital and Johns Hopkins All Children's Hospital from 1/11 to 4/18. Children were defined as achieving drug-free diet (DFD) status if they started the KD on at least 1 ASD and achieved a period of time where they were on the KD alone. Over the time period, 232 children were evaluated; DFD status occurred in 43 (18.5%), of which 32 (13.8% of the full cohort) remained off ASDs for the remainder of their KD treatment course. Eleven children restarted ASD after a mean of 7 months. Children achieving DFD therapy were more likely to be younger, have fewer ASDs at KD onset, have Glut1 deficiency or epilepsy with myoclonic-atonic seizures, but were less likely to have Lennox-Gastaut syndrome or a gastrostomy tube.
生酮饮食（KD）通常不仅用于减少癫痫发作，还用于潜在地使癫痫患儿逐渐减少抗癫痫药物（ASD）。尽管已经有几项关于 KD 减少 ASD 的出版物，但尚不清楚完全停药的频率是多少。我们回顾了 2011 年 1 月 11 日至 2018 年 4 月 18 日期间在约翰霍普金斯医院和约翰霍普金斯所有儿童医院开始 KD 的所有儿童的图表。如果儿童开始 KD 时至少使用了 1 种 ASD，并达到了单独使用 KD 的一段时间，则定义为达到无药物饮食（DFD）状态。在此期间，有 232 名儿童接受了评估；有 43 名（占整个队列的 18.5%）达到 DFD 状态，其中 32 名（DFD 状态儿童的 13.8%）在 KD 治疗过程的其余时间内仍未使用 ASD。11 名儿童在平均 7 个月后重新开始使用 ASD。达到 DFD 治疗的儿童更可能年龄较小，在 KD 开始时使用的 ASD 较少，患有 Glut1 缺乏症或肌阵挛-猝倒性癫痫，但不太可能患有 Lennox-Gastaut 综合征或胃造口管。
