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Abstract：
OBJECTIVE: Ketogenic dietary therapies (KDT) produce anticonvulsant and neuroprotective effects, reduce seizures and improve the cognitive state in patients with epilepsy. Our purpose was to evaluate the effects of KDT in children with refractory epilepsy (effectiveness, side effects, impact on nutritional status and growth).
METHODS: A retrospective and prospective observational descriptive study was conducted in a Spanish tertiary hospital (January 2000 to December 2018). One hundred sixty pediatric patients with epilepsy were treated with KDT (82 males; mean age 5 years 9 months). Seizures, anti-epileptic drugs, anthropometric measures, side effects, and laboratory assessment were monitored baseline and at 3, 6, 12 and 24 months after the onset of KDT.
RESULTS: In these time intervals, the seizure-free patients were: 13.7, 12.5, 14.4 and 10.6%, respectively, and a reduction of seizures≥50% was achieved in 41.9, 37.5, 28.7 and 16.2%. Side effects were frequent, especially digestive disorders, hypercalciuria, hypoglycemia, hepatic dysfunction and dyslipidemia. Prealbumin, retinol binding protein, vitamin A and magnesium decreased significantly. Height was affected, especially in children below 2 years.
CONCLUSIONS: KDT are effective for refractory epilepsy in children. However, adverse effects are frequent, and it may affect nutritional status and growth.
METHODS: A retrospective and prospective observational descriptive study was conducted in a Spanish tertiary hospital (January 2000 to December 2018). One hundred sixty pediatric patients with epilepsy were treated with KDT (82 males; mean age 5 years 9 months). Seizures, anti-epileptic drugs, anthropometric measures, side effects, and laboratory assessment were monitored baseline and at 3, 6, 12 and 24 months after the onset of KDT.
RESULTS: In these time intervals, the seizure-free patients were: 13.7, 12.5, 14.4 and 10.6%, respectively, and a reduction of seizures≥50% was achieved in 41.9, 37.5, 28.7 and 16.2%. Side effects were frequent, especially digestive disorders, hypercalciuria, hypoglycemia, hepatic dysfunction and dyslipidemia. Prealbumin, retinol binding protein, vitamin A and magnesium decreased significantly. Height was affected, especially in children below 2 years.
CONCLUSIONS: KDT are effective for refractory epilepsy in children. However, adverse effects are frequent, and it may affect nutritional status and growth.
摘要：
目的：生酮饮食疗法（KDT）产生抗惊厥和神经保护作用，减少癫痫发作，改善癫痫患者的认知状态。我们的目的是评估KDT对难治性癫痫儿童的影响(有效性，副作用,对营养状况和生长的影响)。
方法：在西班牙一家三级医院（2000年1月至2018年12月）进行了一项回顾性和前瞻性观察性描述性研究。160例小儿癫痫患者接受了KDT治疗（男性82例；平均年龄5岁9个月）。癫痫发作,抗癫痫药物,人体测量,副作用,和实验室评估在基线和KDT发病后3,6,12和24个月进行监测.
结果：在这些时间间隔中，无癫痫患者分别为：13.7、12.5、14.4和10.6％，分别,41.9、37.5、28.7和16.2％的癫痫发作减少≥50％。副作用很频繁,尤其是消化系统疾病,高钙尿症,低血糖,肝功能异常和血脂异常。前白蛋白,视黄醇结合蛋白，维生素A和镁显著下降。身高受到影响,尤其是2岁以下的儿童。
结论：KDT治疗儿童难治性癫痫有效。然而,不良反应频繁,它可能会影响营养状况和生长。
方法：在西班牙一家三级医院（2000年1月至2018年12月）进行了一项回顾性和前瞻性观察性描述性研究。160例小儿癫痫患者接受了KDT治疗（男性82例；平均年龄5岁9个月）。癫痫发作,抗癫痫药物,人体测量,副作用,和实验室评估在基线和KDT发病后3,6,12和24个月进行监测.
结果：在这些时间间隔中，无癫痫患者分别为：13.7、12.5、14.4和10.6％，分别,41.9、37.5、28.7和16.2％的癫痫发作减少≥50％。副作用很频繁,尤其是消化系统疾病,高钙尿症,低血糖,肝功能异常和血脂异常。前白蛋白,视黄醇结合蛋白，维生素A和镁显著下降。身高受到影响,尤其是2岁以下的儿童。
结论：KDT治疗儿童难治性癫痫有效。然而,不良反应频繁,它可能会影响营养状况和生长。
