College of Allied Health Professions, University of Nebraska Medical Center, 984045 Nebraska Medical Center, Omaha, NE 68198-4045, USA.
Department of Neurological Sciences, University of Nebraska Medical Center, 988440 Nebraska Medical Center, Omaha, NE 68198-8440, USA.
Nutrients. 2020 Jun 17;12(6):1809. doi: 10.3390/nu12061809.
Epilepsy in the pediatric and adolescent populations is a devastating condition where individuals are prone to recurrent epileptic seizures or changes in behavior or movement that is the direct result of a primary change in the electrical activity in the brain. Although many children with epilepsy will have seizures controlled with antiseizure medications (ASMs), a large percentage of patients are refractory to drug therapy and may consider initiating a ketogenic diet. The term Ketogenic Diet or Ketogenic Diet Therapy (KDT) refers to any diet therapy in which dietary composition results in a ketogenic state of human metabolism. Currently, there are 4 major Ketogenic diet therapies-the classic ketogenic diet (cKD), the modified Atkins diet (MAD), the medium chain triglyceride ketogenic diet (MCTKD) and the low glycemic index treatment (LGIT). The compositions of the 4 main KDTs differ and limited evidence to distinguish the efficacy among different diets currently exists. Although it is apparent that more randomized controlled trials (RCTs) and long-term studies are needed to evaluate efficacy, side effects and individual response to the diet, it is imperative to study and understand the metabolic profiles of patients with epilepsy in order to isolate which dietary restrictions are necessary to maximize clinical benefit.
儿科和青少年人群中的癫痫是一种破坏性疾病，个体容易出现反复癫痫发作或行为或运动的变化，这是大脑电活动的主要变化直接导致的。尽管许多癫痫患儿通过抗癫痫药物 (ASMs) 可以控制发作，但仍有很大比例的患者对药物治疗无反应，可能会考虑开始生酮饮食。“生酮饮食”或“生酮饮食疗法 (KDT)”是指任何一种饮食疗法，其中饮食成分导致人体代谢呈酮症状态。目前，有 4 种主要的生酮饮食疗法——经典生酮饮食 (cKD)、改良阿特金斯饮食 (MAD)、中链甘油三酯生酮饮食 (MCTKD) 和低血糖指数治疗 (LGIT)。这 4 种主要的 KDT 饮食的组成不同，目前还存在有限的证据可以区分不同饮食的疗效。尽管显然需要更多的随机对照试验 (RCTs) 和长期研究来评估疗效、副作用以及个体对饮食的反应，但研究和了解癫痫患者的代谢特征至关重要，以便分离出最大限度地提高临床获益所需的饮食限制。
