Department of Pediatric Neurology, China Medical University Shenzhen Children's Hospital, Shenzhen, Guangdong, China; China Medical University, Shenyang, Liaoning, China.
Department of Pediatric Neurology, China Medical University Shenzhen Children's Hospital, Shenzhen, Guangdong, China.
Seizure. 2022 Jan;94:183-188. doi: 10.1016/j.seizure.2021.10.021. Epub 2021 Oct 30.
To evaluate the retention rate, efficacy, and safety of ketogenic diet therapy for drug-resistant epilepsy in children and compare the results with those of a previous cohort at our institution.
A total of 634 children with drug-resistant epilepsy were included in this retrospective study. Patients were categorized into two groups. The previous cohort was included as a control group and included 317 children assessed between 2004 and 2011, whereas the current group included 317 children assessed between 2015 and 2019. The control group was provided care as usual, and the current group additionally adopted the goal and long-term management strategy. Outcomes were measured with respect to retention rate, seizure reduction, and adverse reaction.
Patient demographics were consistent between both cohorts. Compared to the past ten years, the retention rate significantly increased over time (3 months: 62.8% vs. 82.0%, p <0.001; 6 months: 42.0% vs. 60.6%, p <0.001; 12 months: 24.3% vs. 34.1%, p = 0.007), and the response rate was significantly improved (3 months: 35.0% vs. 55.5%, p <0.001; 6 months: 26.2% vs. 43.2%, p <0.001; 12 months: 18.6% vs. 31.5%, p <0.001). Constipation (n = 79, 24.9%) was the most common side effect in the current cohort. Food refusal and hypoproteinaemia reduced to 3.5% and 0.9%, respectively.
Goal and long-term management is effective for ketogenic diet therapy, which significantly improved the ketogenic diet retention rate, efficacy, and incidence of adverse reactions. This strategy has promising applicability in ketogenic diet therapy.
ChiCTR-IIR-16,008,342.
评估儿童耐药性癫痫的生酮饮食治疗的保留率、疗效和安全性，并将结果与本机构之前的队列进行比较。
本回顾性研究共纳入 634 例耐药性癫痫患儿。患者分为两组。将之前的队列作为对照组，纳入 2004 年至 2011 年评估的 317 例患儿，而当前组纳入 2015 年至 2019 年评估的 317 例患儿。对照组接受常规治疗，当前组额外采用目标和长期管理策略。通过保留率、癫痫发作减少和不良反应来衡量结果。
两组患者的人口统计学特征一致。与过去十年相比，保留率随时间显著增加（3 个月：62.8%对 82.0%，p<0.001；6 个月：42.0%对 60.6%，p<0.001；12 个月：24.3%对 34.1%，p=0.007），反应率也显著提高（3 个月：35.0%对 55.5%，p<0.001；6 个月：26.2%对 43.2%，p<0.001；12 个月：18.6%对 31.5%，p<0.001）。当前组最常见的副作用是便秘（n=79，24.9%）。拒食和低蛋白血症减少至 3.5%和 0.9%。
目标和长期管理对生酮饮食治疗有效，显著提高了生酮饮食的保留率、疗效和不良反应发生率。该策略在生酮饮食治疗中具有很好的适用性。
ChiCTR-IIR-16,008,342。
