International Recommendations for the Management of Adults Treated With Ketogenic Diet Therapies

被引：45

作者：

Cervenka, Mackenzie C. ^{[1
]}

Wood, Susan ^{[2
]}

Bagary, Manny ^{[3
]}

Balabanov, Antoaneta ^{[4
]}

Bercovici, Eduard ^{[5
]}

Brown, Mesha-Gay ^{[6
]}

Devinsky, Orrin ^{[7
]}

Di Lorenzo, Cherubino ^{[8
]}

Doherty, Colin P. ^{[9
,10
]}

Felton, Elizabeth ^{[11
]}

Healy, Laura A. ^{[12
]}

Klein, Pavel ^{[13
]}

Kverneland, Magnhild ^{[14
]}

Lambrechts, Danielle ^{[15
,16
]}

Langer, Jennifer ^{[17
]}

Nathan, Janak ^{[18
]}

Munn, Jude ^{[3
]}

Nguyen, Patty ^{[19
]}

Phillips, Matthew ^{[20
]}

Roehl, Kelly ^{[4
]}

Tanner, Adrianna ^{[21
]}

Williams, Clare ^{[22
]}

Zupec-Kania, Beth ^{[23
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Dept Neurol, Baltimore, MD 21205 USA

[2] Matthews Friends Clin Ketogen Dietary Therapies, Lingfield, Surrey, England

[3] The Barberry, Complex Epilepsy & Sleep Serv, Birmingham, W Midlands, England

[4] Rush Univ, Med Ctr, Dept Neurol, Chicago, IL 60612 USA

[5] Univ Toronto, Dept Neurol, Toronto, ON, Canada

[6] Univ Colorado, Dept Neurol, Denver, CO 80202 USA

[7] NYU, Sch Med, Dept Neurol, New York, NY 10003 USA

[8] Sapienza Univ Rome Polo Pontino, Dept Med Surg Sci & Biotechnol, Rome, Italy

[9] Trinity Coll Dublin, Acad Unit Neurol, Dublin, Ireland

[10] FutureNeuro, Dublin, Ireland

[11] UW Hlth, Dept Neurol, Madison, WI USA

[12] St James Hosp, Dept Clin Nutr, Dublin, Ireland

[13] Midatlantic Epilepsy & Sleep Ctr, Bethesda, MD USA

[14] Natl Ctr Epilepsy, Oslo, Norway

[15] Kempenhaeghe, Acad Ctr Epileptol, Dept Neurol, Heeze, Netherlands

[16] Maastricht Univ, Med Ctr, Heeze, Netherlands

[17] Univ Virginia, Dept Neurol, Charlottesville, VA USA

[18] Shushrusha Hosp, Dept Neurol, Mumbai, Maharashtra, India

[19] Univ Coll London Hosp NHS Fdn Trust, Charles Dent Metab Unit, London, England

[20] Waikato Hosp, Dept Neurol, Hamilton, New Zealand

[21] Mercy Hlth Hauenstein Neurosci, Grand Rapids, MI USA

[22] Mater Grp, Dept Dietet & Foodserv, South Brisbane, Qld, Australia

[23] Charlie Fdn Ketogen Therapies, Santa Monica, CA USA

来源：

NEUROLOGY-CLINICAL PRACTICE | 2021年 / 11卷 / 05期

关键词：

MODIFIED ATKINS DIET; REFRACTORY EPILEPSY; INTRACTABLE EPILEPSY; CHILDHOOD EPILEPSY; TREATMENT OPTION; EFFICACY; CHILDREN; TOLERABILITY; ADOLESCENTS; IMPACT;

D O I：

10.1212/CPJ.0000000000001007

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective To evaluate current clinical practices and evidence-based literature to establish preliminary recommendations for the management of adults using ketogenic diet therapies (KDTs). Methods A 12-topic survey was distributed to international experts on KDTs in adults consisting of neurologists and dietitians at medical institutions providing KDTs to adults with epilepsy and other neurologic disorders. Panel survey responses were tabulated by the authors to determine the common and disparate practices between institutions and to compare these practices in adults with KDT recommendations in children and the medical literature. Recommendations are based on a combination of clinical evidence and expert opinion regarding management of KDTs. Results Surveys were obtained from 20 medical institutions with >2,000 adult patients treated with KDTs for epilepsy or other neurologic disorders. Common side effects reported are similar to those observed in children, and recommendations for management are comparable with important distinctions, which are emphasized. Institutions differ with regard to recommended biochemical assessment, screening, monitoring, and concern for long-term side effects, and further investigation is warranted to determine the optimal clinical management. Differences also exist between screening and monitoring practices among adult and pediatric providers. Conclusions KDTs may be safe and effective in treating adults with drug-resistant epilepsy, and there is emerging evidence supporting the use in other adult neurologic disorders and general medical conditions as well. Therefore, expert recommendations to guide optimal care are critical as well as further evidence-based investigation.

引用

页码：385 / 397

页数：13

共 62 条

[1] Interest in the Ketogenic Diet Grows for Weight Loss and Type 2 Diabetes [J].

Abbasi, Jennifer .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2018, 319 (03) :215-217

[2] Epilepsy in adults - Results of treatment by ketogenic diet in one hundred cases [J].

Barborka, CJ .

ARCHIVES OF NEUROLOGY AND PSYCHIATRY, 1930, 23 (05) :904-914

[3] Fatal propofol infusion syndrome in association with ketogenic diet [J].

Baumeister, FAM ;

Oberhoffer, R ;

Liebhaber, GM ;

Kunkel, J ;

Eberhardt, J ;

Holthausen, H ;

Peters, J .

NEUROPEDIATRICS, 2004, 35 (04) :250-252

[4]

Berry-Kravis T, 2001, EPILEPSIA, V42, P1445

[5] Long-term effects of a ketogenic diet on body composition and bone mineralization in GLUT-1 deficiency syndrome: A case series [J].

Bertoli, Simona ;

Trentani, Claudia ;

Ferraris, Cinzia ;

De Giorgis, Valentina ;

Veggiotti, Pierangelo ;

Tagliabue, Anna .

NUTRITION, 2014, 30 (06) :726-728

[6] The Current Status of the Ketogenic Diet in Psychiatry [J].

Bostock, Emmanuelle C. S. ;

Kirkby, Kenneth C. ;

Taylor, Bruce V. M. .

FRONTIERS IN PSYCHIATRY, 2017, 8

[7] Preliminary Report on the Feasibility and Efficacy of the Modified Atkins Diet for Treatment of Mild Cognitive Impairment and Early Alzheimer's Disease [J].

Brandt, Jason ;

Buchholz, Alison ;

Henry-Barron, Bobbie ;

Vizthum, Diane ;

Avramopoulos, Dimitrios ;

Cervenka, Mackenzie C. .

JOURNAL OF ALZHEIMERS DISEASE, 2019, 68 (03) :969-981

[8]

Cervenka MC, 2017, NEUROLOGY, V88, P938, DOI [10.1212/WNL.0000000000003690, 10.1212/wnl.0000000000003690]

[9] Establishing an Adult Epilepsy Diet Center: Experience, efficacy and challenges [J].

Cervenka, Mackenzie C. ;

Henry, Bobbie J. ;

Felton, Elizabeth A. ;

Patton, Katlyn ;

Kossoff, Eric H. .

EPILEPSY & BEHAVIOR, 2016, 58 :61-68

[10] The impact of the modified Atkins diet on lipid profiles in adults with epilepsy [J].

Cervenka, Mackenzie C. ;

Patton, Katlyn ;

Eloyan, Ani ;

Henry, Bobbie ;

Kossoff, Eric H. .

NUTRITIONAL NEUROSCIENCE, 2016, 19 (03) :131-137

← 1 2 3 4 5 6 7 →