난치성 소아 간질에시 케톤성 식이요법의 효과
The Efficacy of Ketogenic Diet in Intractable Childhood Epilepsy
김흥동,
소속 상세정보
김흥동 ( Kim Heung-Dong )
인제대학교 의과대학 상계백병원 소아과학교실
KMID : 0877219980020020127
Abstract
Purpose : Ketogenic diet Is one of the effective anti-epileptic treatments for intractable childhood epilepsy. This study was performed to reveal the anti-epileptic efficacy, complication, tolerance, and other neurological effects of ketogenic diet.
Methods : Classic 4 : 1 ketogenic diet was introduced to 49 patients with intractable childhood epilepsy. Anti-epileptic efficacies were studied according to seizure classifications and epileptic syndromes, and other clinical features such as complications and tolerances were observed.
Results : Complete seizure control was observed in 78 patients (36.7%), and seizure reduction over 90% was obtained in 9 patients (18.4%). Ketogenic diet was most effective in infantile spasm with seizure free rate of 60%, and least effective in Lennox-Gastaut syndrome with seizure free rate of 26.7%. Improved cognitive function was noticed in 63.2% of patients, and improved behavior was seen in 27.8% of 18 patients with behavior disorder. Gastrointestinal complications such as vomiting and diarrhea was combined in 67.3%, controlled by symptomatic medications. Lipoid pneumonia was complicated in 4 patients, and prolonged increase of serum uric acid over 1 month was seen in 3 patients. Ketogenic diet was difficult to be maintained for a long duration especially in patients with incomplete seizure control.
Conclusion : Ketogenic diet was relatively safe and highly effective anti-epileptic treatment in many patients with intractable childhood epilepsy. Complete seizure reduction rate was highest in infantile spasm.
키워드
간질; 케톤성 식이요법; 영아 연축; Lennox-Gastaut 증후군
Epilepsy; Ketogenic diet; Intractable childhood epilepsy; Infantile spasm; Lennox-Gastaut syndrome; Complication
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