[논문]The use of ketogenic diet in special situations: expanding use in intractable epilepsy and other neurologic disorders

Lee, Mun-Hyang

doi:10.3345/kjp.2012.55.9.316

The use of ketogenic diet in special situations: expanding use in intractable epilepsy and other neurologic disorders 원문보기

Korean journal of pediatrics, v.55 no.9, 2012년, pp.316 - 321

Lee, Mun-Hyang (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)

Abstract ▼ AI-Helper

The ketogenic diet has been widely used and proved to be effective for intractable epilepsy. Although the mechanisms underlying its antiepileptic effects remain to be proven, there are increasing experimental evidences for its neuroprotective effects along with many researches about expanding use of the diet in other neurologic disorders. The first success was reported in glucose transporter type 1 deficiency syndrome, in which the diet served as an alternative metabolic source. Many neurologic disorders share some of the common pathologic mechanisms such as mitochondrial dysfunction, altered neurotransmitter function and synaptic transmission, or abnormal regulation of reactive oxygen species, and the role of the ketogenic diet has been postulated in these mechanisms. In this article, we introduce an overview about the expanding use and emerging trials of the ketogenic diet in various neurologic disorders excluding intractable epilepsy and provide explanations of the mechanisms in that usage.

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문제 정의

An alternative use of the ketogenic diet has been tried in various conditions (Table 1). This review will cover the areas of established evidence and dietary treatments in neurologic disorders other than epilepsy and summarize the clinical researches to date.

대상 데이터

The use of the ketogenic diet in super-refractory status epilepticus have mostly been reported in children. The first report was conducted with six children with super-refractory status epilepticus responding to the diet. In 2010, Nabbout et al.
Another prospective study assessed the efficacy of the ketogenic diet in patients with MAE. The study included 11 patients treated with the ketogenic diet for at least 18 months. A total of six patients remained on the diet and two patients became seizure free and another two showed more than 75% seizure reduction.
The first large study using the ketogenic diet to Dravet syndrome was reported in 2005. The study included 52 patients who met the diagnostic criteria for Dravet syndrome. Twenty patients were given the diet and thirteen continued on the diet for at least one year.

후속연구

The use of the ketogenic diet in various conditions is mainly based on the idea that alterations in metabolism may have a neuroprotective effect or changes in neuronal excitability as well as metabolic source. However, the exact mechanisms of action await further investigations; with those, the more expanding use of ketogenic diet will be possible in the future.

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