KETOGENIC DIET TREATMENT FOR STATUS EPILEPTICUS

The ketogenic diet (KD) is a high fat normoproteic, low carbohydrate diet considered in recent years as an alternative treatment option for patients with refractory status epilepticus (RSE) or super-refractory status epilepticus (SRSE), both, in children and adults. The aim of current research is to review and compare the efficacy of KD in children and adults with RSE and SRSE regardless of underlying aetiology. We performed a retrospective PubMed search between June 1997 until 30th of October 2017 and selected all articles in which KD was used for the treatment of children and adults with status epilepticus refractory to standard therapy. 120 patients (adults and children) with RSE and SRSE were identified. An important proportion of patients (92/120 similar to 77%, 64 children and 28 adults) responded to KD therapy. In conclusion, KD is proving to be a valuable therapeutic option in the intensive care units for the treatment of RSE and SRSE in children and adults, available data showing efficacy mostly but not limited to (febrile infection related to encephalopathy in school aged children) FIRES in children and encephalitis in adults. Specific protocols and training should be made available in intensive care units in order to implement and manage KD in children and adults with status epilepticus who do not respond to standard therapeutic approaches.