Therapy and Dietetics, Royal Manchester Children's Hospital, Manchester, UK.
School of Health & Society, University of Salford, Greater Manchester, UK.
J Hum Nutr Diet. 2020 Feb;33(1):98-105. doi: 10.1111/jhn.12697. Epub 2019 Aug 20.
In 2012, the National Institute for Health and Care Excellence (NICE) Clinical Guidelines for Epilepsies: Diagnosis and Management (CG137) included, for the first time, ketogenic diets (KDs) as a treatment option for drug-resistant paediatric epilepsy. The recommendation was made to refer children and young people with epilepsy whose seizures have not responded to appropriate anti-epileptic drugs to a tertiary paediatric epilepsy specialist for consideration of the use of KDs. We aimed to assess the impact of this change in guidance on the numbers of ketogenic centres and patients following KDs for epilepsy in the UK and Ireland.
An online survey was circulated to ketogenic dietitians from the UK and Ireland. The results were compared with similar surveys published in 2000 and 2010.
The number of centres offering KDs for treatment of epilepsy has risen from 22 in 2000, to 28 in 2010, and to 39 in 2017 (77% overall increase). Seven of these centres accept adult referrals, in comparison to only two centres in 2010. Patient numbers have increased from 101 in 2000 to 754 in 2017. In total, 267 patients are waiting to commence KD at 31 centres.
Over the last 7 years, the number of patients treated with a KD for epilepsy in the UK and Ireland has increased by 647%, with a 77% increase in the number of centres offering KDs. Despite this rapid growth, there is ongoing demand for patients to be considered for dietary therapy, highlighting the need for continued expansion of KD services nationally.
2012 年，英国国家卫生与保健优化研究所（NICE）发布的《癫痫症临床指南：诊断与管理》（CG137）首次将生酮饮食（KD）纳入耐药性小儿癫痫的治疗选择。该指南建议，将抗癫痫药物治疗无效的癫痫患儿和青少年转介至三级儿科癫痫专科，以考虑使用 KD。本研究旨在评估这一指南变化对英国和爱尔兰 KD 治疗癫痫的中心数量和患者数量的影响。
我们向英国和爱尔兰的 KD 营养师分发了在线调查问卷。结果与 2000 年和 2010 年发表的类似调查进行了比较。
提供 KD 治疗癫痫的中心数量从 2000 年的 22 家增加到 2010 年的 28 家，再增加到 2017 年的 39 家（总体增长 77%）。其中 7 家中心可接受成人转诊，而 2010 年仅有 2 家。患者数量从 2000 年的 101 例增加到 2017 年的 754 例。在 31 家中心中，共有 267 名患者等待开始 KD。
在过去 7 年中，英国和爱尔兰接受 KD 治疗癫痫的患者数量增加了 647%，提供 KD 的中心数量增加了 77%。尽管增长迅速，但仍有大量患者需要考虑进行饮食治疗，这突显了在全国范围内持续扩大 KD 服务的必要性。
