Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Eur J Clin Nutr. 2019 Dec;73(12):1594-1597. doi: 10.1038/s41430-019-0471-4. Epub 2019 Jul 17.
The ketogenic diet (KD) has been shown to be effective in controlling super-refractory status epilepticus (SRSE) in adult. To the best of our knowledge, there has been no previous report of the MCT KD in adult with SRSE.
A 19-year-old female was hospitalized due to SRSE from autoimmune encephalitis despite pulsed methylprednisolone, intravenous immunoglobulin, and eight antiepileptic drug treatments. The MCT KD treatment was initiated and rapid seizure control was observed within 6 days despite negative ketosis.
We report the first successful treatment with MCT KD in a female adult with SRSE who was refractory to classic KD with severe hypertriglyceridemia, and reviewed all SE adults with KD treatment. Dramatic seizure control without positive ketosis might lead to a new focus on fatty acids instead, paving the way for further prospective study regarding the effects of the MCT KD in this fatal condition.
生酮饮食（KD）已被证明可有效控制成人难治性癫痫持续状态（SRSE）。据我们所知，以前没有关于成人 SRSE 使用中链甘油三酯 KD（MCT KD）的报道。
一名 19 岁女性因自身免疫性脑炎导致 SRSE 而住院，尽管已接受脉冲甲基强的松龙、静脉注射免疫球蛋白和 8 种抗癫痫药物治疗。尽管未出现酮症，但仍开始使用 MCT KD 治疗，在 6 天内迅速控制了癫痫发作。
我们报告了首例 MCT KD 治疗女性成人 SRSE 成功的病例，该患者对经典 KD 治疗伴有严重高甘油三酯血症耐药，并回顾了所有 KD 治疗的 SE 成人患者。无阳性酮症但显著控制癫痫发作可能会促使人们关注脂肪酸，为进一步研究 MCT KD 在这种致命情况下的作用铺平道路。
