Nkole Kafula Lisa, Kawatu Nfwama, Patel Archana A, Kanyinji Chimbizyani, Njobvu Theresa, Chipeta James, Musuku John, Ciccone Ornella, Tarrant Stacey, Bergin Ann Marie
University Teaching Hospitals-Children's Hospital, Nationalist road, Lusaka, Zambia.
University of Zambia, School of Medicine, Department of Paediatrics and Child Health, Lusaka, Zambia.
Epilepsy Behav Rep. 2020 Jul 3;14:100380. doi: 10.1016/j.ebr.2020.100380. eCollection 2020.
Globally, drug-resistant epilepsy affects one third of people living with epilepsy. With limitations in treatment options for refractory epilepsy in resource-limited regions, ketogenic diet therapy is an important option to consider. Utilizing the 2015 International League Against Epilepsy recommended minimum requirements for ketogenic diet therapy, three male children with refractory epilepsy, aged 2.5, 6.5 and 10 years, were initiated on the classical ketogenic diet using locally available food in August 2017 at University Teaching Hospitals-Children's Hospital in Lusaka, Zambia, through partnership with the Epilepsy Program at Boston Children's Hospital in the United States. Following successful initiation in all three children, the diet was discontinued in the 10-year-old due to difficulties complying with the diet. The youngest child demonstrated an over 50% seizure reduction and gained developmental milestones. The third child achieved seizure freedom and showed marked improvement in behaviour. This pilot demonstrates the feasibility of ketogenic diet as an important therapeutic option for refractory epilepsy in Zambia. Given the limitations in treatment choices and medication accessibility, dietary therapy offers an alternative management strategy in our setting. Collaboration with an established ketogenic diet centre contributes to a successful program.
在全球范围内，耐药性癫痫影响着三分之一的癫痫患者。由于资源有限地区难治性癫痫的治疗选择存在局限性，生酮饮食疗法是一个值得考虑的重要选择。利用2015年国际抗癫痫联盟推荐的生酮饮食疗法最低要求，2017年8月，在赞比亚卢萨卡的大学教学医院儿童医院，通过与美国波士顿儿童医院癫痫项目合作，对三名难治性癫痫男童（年龄分别为2.5岁、6.5岁和10岁）采用当地可得食物开始进行经典生酮饮食治疗。在所有三名儿童成功开始治疗后，10岁的儿童因难以遵守饮食规定而停止了饮食治疗。最小的儿童癫痫发作减少了50%以上，并达到了发育里程碑。第三个儿童实现了无癫痫发作，行为也有显著改善。这项试点研究证明了生酮饮食作为赞比亚难治性癫痫重要治疗选择的可行性。鉴于治疗选择和药物可及性的局限性，饮食疗法在我们的环境中提供了一种替代管理策略。与一个成熟的生酮饮食中心合作有助于项目取得成功。
