PDF(Pubmed)
Abstract：
Background and Objectives: Ketogenic diet therapy (KDT) has been used as a non-pharmacological treatment for childhood refractory epilepsy. Its efficacy and safety have been described in numerous studies and reviews. However, there have been fewer studies evaluating the challenges experienced by patients and their family members when starting KDT. When implementing a new treatment method, challenges arise for both the healthcare professionals and patients, making it important to summarize the initial results and compare them with the experiences of other centers. To analyze and evaluate the efficacy and safety of KDT in children with epilepsy, as well as to consider the challenges faced by their parents/caregivers. Materials and Methods: A retrospective analysis of patients\' data (N = 30) and an analysis of the completed questionnaires of the parents/caregivers (N = 22) occurred. Results: In the study group, 66.7% of the patients had a >50% decrease in seizure frequency, and 2/3 of them had a >90% decrease in seizure frequency or were seizure-free, which enabled reducing the anti-seizure medications in 36.4% of the patients, as well as reducing the hospital visits. Cognitive improvement and better alertness were subjectively reported by 59.1% of the parents/caregivers. No dangerous long-term adverse effects of KDT have been observed in the study group. The patients with generalized epilepsy experienced significantly more adverse events. Most of the adverse effects of KDT were related to the digestive system, but usually they were temporary and controllable. The challenges of the parents/caregivers were mostly related to social life issues and financial difficulties; the medical-related challenges were minimal. Conclusions: KDT is an effective and safe treatment option for children with drug-resistant epilepsy, and the challenges faced by families are resolvable. In order to ensure effective KDT, a multidisciplinary team is required. This would ensure smooth and comprehensive care and the timely resolution of emerging problems. The cooperation of the families undergoing KDT is also important, enabling them to share their experiences.
摘要：
背景与目的：生酮饮食疗法（KDT）已被用作儿童难治性癫痫的非药物治疗方法。其有效性和安全性已在许多研究和评论中描述。然而,评估患者及其家庭成员在开始使用KDT时所经历的挑战的研究较少.当实施新的治疗方法时，医疗保健专业人员和患者都面临挑战，重要的是总结初步结果，并将其与其他中心的经验进行比较。分析和评价KDT治疗儿童癫痫的疗效和安全性,以及考虑他们的父母/照顾者面临的挑战。材料和方法：对患者数据进行回顾性分析（N=30），并对父母/照顾者完成的问卷进行分析（N=22）。结果:研究组,66.7%的患者癫痫发作频率下降>50%，其中2/3的患者癫痫发作频率下降>90%或无癫痫发作，这使得36.4%的患者减少了抗癫痫药物，以及减少医院就诊。59.1%的父母/照顾者主观地报告了认知改善和更好的警觉性。在研究组中未观察到KDT的危险长期不良反应。全身性癫痫患者经历了明显更多的不良事件。KDT的大部分不良反应与消化系统有关，但通常它们是暂时的和可控的。父母/照顾者的挑战主要与社会生活问题和经济困难有关；与医疗相关的挑战很小。结论:KDT治疗儿童耐药癫痫是一种安全有效的治疗方案。家庭面临的挑战是可以解决的。为了确保有效的KDT，需要一个多学科小组。这将确保顺利和全面的护理，并及时解决新出现的问题。接受KDT的家庭的合作也很重要，让他们分享他们的经验。
