Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Child Health Department, National Research Centre, Doki, Giza, Egypt.
Acta Neurol Belg. 2020 Apr;120(2):375-380. doi: 10.1007/s13760-020-01310-9. Epub 2020 Feb 27.
Ketogenic diet is a high-fat, low-carbohydrate, and adequate-protein diet. It is well-established as a treatment option for drug-resistant childhood epilepsies. Our study aimed to evaluate Selenium levels and oxidative stress in children receiving ketogenic diet for intractable seizures for 6 months. This is a comparative case-control study included 90 children under 6 years age. They were subdivided into three groups. Group I: Thirty patients with drug-resistant epilepsy under antiepileptic drugs only. Group II: Thirty patients with drug-resistant epilepsy under treatment with ketogenic diet for 6 months and antiepileptic drugs. Group III: Thirty age and sex-matched healthy children as controls. Full history taking with special emphasis on severity and frequency of seizures, neurological examination, anthropometric measurements and laboratory analysis for serum Malonaldehyde, and total antioxidant capacity and Selenium were done for all participants. The frequency and severity of seizures were significantly lower in group II receiving ketogenic diet than group I on antiepileptic drugs only. Selenium levels were significantly lower in epileptic patients in comparison to controls. However, it was markedly lower in the ketogenic diet group. Malonaldehyde levels were significantly higher in epileptic children in comparison to controls, with lower values among ketogenic diet group when compared to patients on antiepileptic drugs only. Total antioxidant capacity levels were significantly lower in epileptic patients in comparison to controls, with higher values among ketogenic diet group as compared to epileptic patients on pharmacological treatment. Ketogenic diet is an effective treatment for refractory epilepsy for its anti-epileptic mechanism. It also may exert antioxidant effects. The nutrient content of the ketogenic diet may not meet the recommended daily allowance for selenium. So, this should be taken into consideration for supplementation of minerals in adequate amounts for patients receiving this diet.
生酮饮食是一种高脂肪、低碳水化合物和适量蛋白质的饮食。它已被确立为治疗耐药性儿童癫痫的一种选择。我们的研究旨在评估接受生酮饮食治疗 6 个月的耐药性癫痫儿童的硒水平和氧化应激。这是一项病例对照研究，纳入了 90 名 6 岁以下的儿童。他们被分为三组。组 I：30 名仅接受抗癫痫药物治疗的耐药性癫痫患者。组 II：30 名接受生酮饮食治疗 6 个月和抗癫痫药物治疗的耐药性癫痫患者。组 III：30 名年龄和性别匹配的健康儿童作为对照组。对所有参与者进行详细的病史采集，特别强调发作的严重程度和频率、神经系统检查、人体测量和实验室分析，包括血清丙二醛、总抗氧化能力和硒。与仅接受抗癫痫药物治疗的组 I 相比，接受生酮饮食治疗的组 II 的发作频率和严重程度显著降低。与对照组相比，癫痫患者的硒水平显著降低；然而，生酮饮食组的硒水平明显更低。与对照组相比，癫痫患儿的丙二醛水平显著升高，而与仅接受抗癫痫药物治疗的患者相比，生酮饮食组的丙二醛水平较低。与对照组相比，癫痫患者的总抗氧化能力水平显著降低，而与接受药物治疗的癫痫患者相比，生酮饮食组的总抗氧化能力水平更高。生酮饮食是一种有效的治疗难治性癫痫的方法，其抗癫痫机制。它也可能发挥抗氧化作用。生酮饮食的营养成分可能无法满足硒的推荐日摄入量。因此，对于接受这种饮食的患者，应考虑适量补充矿物质。
