Comprehensive Epilepsy Center, Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
Comprehensive Epilepsy Center, Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
Epilepsy Res. 2020 May;162:106319. doi: 10.1016/j.eplepsyres.2020.106319. Epub 2020 Mar 10.
The use of ketogenic diet therapies (KDT) in adults has expanded in the last two decades and has been accompanied by a surge of new retrospective as well as prospective studies evaluating its efficacy in adults with epilepsy. In this review article, we will highlight the recent clinical trials and advances in the use of the ketogenic diet therapy (KDT) in adult patients with epilepsy. We will analyze the responder rate in regard to the epilepsy syndrome (focal vs generalized) to identify adults who are optimal to consider for KDT. In addition to its role in treating patients with chronic epilepsy, we will explore the emerging use of the KDT in the critical care setting in adults with refractory and super-refractory status epilepticus as well as other neurologic disorders. Finally, we will discuss special considerations for the use of KDT in adults with epilepsy including its potential long-term effects on bone and cardiovascular health, and its use in pregnancy.
生酮饮食疗法(KDT)在成人中的应用在过去二十年中不断扩大,同时伴随着大量新的回顾性和前瞻性研究评估其在成人癫痫中的疗效。在这篇综述文章中,我们将重点介绍最近的临床试验和生酮饮食疗法(KDT)在成人癫痫患者中的应用进展。我们将分析针对癫痫综合征(局灶性与全面性)的应答率,以确定最适合接受 KDT 的成人患者。除了在治疗慢性癫痫患者中的作用外,我们还将探讨 KDT 在成人难治性和超难治性癫痫持续状态以及其他神经疾病的重症监护环境中的新兴应用。最后,我们将讨论 KDT 在成人癫痫患者中的使用的特殊考虑因素,包括其对骨骼和心血管健康的潜在长期影响,以及在怀孕期间的使用。