scholarly journals D.01 Earlier treatment with the Ketogenic Diet improves seizure outcome in early-onset drug-resistant epilepsy

2016 ◽  
Vol 43 (S2) ◽  
pp. S13-S13
Author(s):  
M Irwin ◽  
S Aimola ◽  
H Lowe ◽  
Y Liu ◽  
M Zak ◽  
...  
Keyword(s):  
Ketogenic Diet ◽  
Early Onset ◽  
Past History ◽  
Seizure Outcome ◽  
Drug Resistant ◽  
Treatment Delays ◽  
Young Infants ◽  
History Of ◽  
Drug Resistant Epilepsy

Background: The ketogenic diet (KD) is used to treat severe childhood-onset epileptic encephalopathies, such as Infantile Spasms (IS). Unfortunately, limited resources for KD initiation result in treatment delays. We ask if earlier KD treatment of early-onset drug-resistant epilepsy results in better seizure outcomes. Methods: Children who started KD before age 4 years between 2000-present at SickKids Hospital were identified. Six-month seizure outcome was calculated as percent of pre-diet baseline seizure frequency (BSF). Results: 67 children were identified. 30 (44.8%) started KD <2 years old, 37 (55.2%) started KD 2-4 years old. Among <2 years old group, 83.3% achieved 50% reduction in BSF and 36.7% achieved 90% reduction. Among 2-4 year old group, 62.2% achieved 50% reduction in BSF and 24.3% achieved 90% reduction. 38 children had a history of IS; 17 with IS at diet initiation and 21 with past history of IS. 41.2% of the spasms cohort achieved 90% reduction in BSF, compared to 23.8% of the post-spasms cohort. Conclusions: KD was more effective when started before age 2 years than 2-4 years, and more effective in children with IS than in children with past history of IS. A rapid protocol for KD initiation in young infants and children may improve long-term outcomes

Long-term effectiveness and adverse effects of ketogenic diet therapy in infants with drug-resistant epilepsy treated at a single center in Argentina

2021 ◽  
pp. 106793
Author(s):  
Marisa Armeno ◽  
Antonella Verini ◽  
Eugenia Caballero ◽  
Araceli Cresta ◽  
Gabriela Reyes Valenzuela ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Ketogenic Diet ◽  
Diet Therapy ◽  
Drug Resistant ◽  
Single Center ◽  
Drug Resistant Epilepsy

scholarly journals Ketogenic Diet Therapies for Seizures and Status Epilepticus

2020 ◽  
Vol 40 (06) ◽  
pp. 719-729
Author(s):  
Tanya J. W. McDonald ◽  
Mackenzie C. Cervenka
Keyword(s):  
Status Epilepticus ◽  
Ketogenic Diet ◽  
Care Setting ◽  
Drug Resistant ◽  
Anesthetic Agents ◽  
Ketogenic Diets ◽  
Potential Efficacy ◽  
Low Carbohydrate ◽  
History Of ◽  
Drug Resistant Epilepsy

AbstractKetogenic diet therapies are high-fat, low-carbohydrate diets designed to mimic a fasting state. Although initially developed nearly one century ago for seizure management, most clinical trials for the management of drug-resistant epilepsy in children as well as adults have been conducted over the last 3 decades. Moreover, ketogenic diets offer promising new adjunctive strategies in the critical care setting for the resolution of acute status epilepticus when traditional antiseizure drugs and anesthetic agents fail. Here, we review the history of ketogenic diet development, the clinical evidence supporting its use for the treatment of drug-resistant epilepsy in children and adults, and the early evidence supporting ketogenic diet feasibility, safety, and potential efficacy in the management of status epilepticus.

scholarly journals Outcomes after Epilepsy Surgery

2012 ◽  
Vol 39 (S6) ◽  
pp. S25-S29 ◽  
Author(s):  
José F. Téllez-Zenteno ◽  
Lizbeth Hernandez-Ronquillo ◽  
Jorge Burneo
Keyword(s):  
Epilepsy Surgery ◽  
Seizure Outcome ◽  
Drug Resistant ◽  
Long Term Outcomes ◽  
Short Term ◽  
Psychiatric Outcomes ◽  
Drug Resistant Epilepsy ◽  
Complications And Mortality ◽  
Important Evidence

Epilepsy surgery is a highly effective and durable treatment for specific types of drug resistant epilepsy such as temporal lobe epilepsy. assessment of outcomes is essential in epilepsy surgery, which is an irreversible intervention for a chronic condition. Excellent short-term results of resective epilepsy surgery have been established. In the last years more information regarding long term outcomes have been published. This article reviews the best available evidence about the best measures to assess outcomes and the most important evidence. The outcomes reviewed in this article are the following: seizure outcome, social and psychiatric outcomes, complications and mortality.

Vagus nerve stimulation for drug-resistant epilepsy

2019 ◽  
Vol 20 (3) ◽  
pp. 189-198 ◽  
Author(s):  
Laura Pérez-Carbonell ◽  
Howard Faulkner ◽  
Sean Higgins ◽  
Michalis Koutroumanidis ◽  
Guy Leschziner
Keyword(s):  
Vagus Nerve ◽  
Seizure Frequency ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Therapeutic Option ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy ◽  
Randomised Controlled

Vagus nerve stimulation (VNS) is a neuromodulatory therapeutic option for drug-resistant epilepsy. In randomised controlled trials, VNS implantation has resulted in over 50% reduction in seizure frequency in 26%–40% of patients within 1 year. Long-term uncontrolled studies suggest better responses to VNS over time; however, the assessment of other potential predictive factors has led to contradictory results. Although initially designed for managing focal seizures, its use has been extended to other forms of drug-resistant epilepsy. In this review, we discuss the evidence supporting the use of VNS, its impact on seizure frequency and quality of life, and common adverse effects of this therapy. We also include practical guidance for the approach to and the management of patients with VNS in situ.

scholarly journals Reported History of Measles and Long-term Impact on Antibody to Tetanus in Children 6–59 Months of Age Receiving DTP in the Democratic Republic of Congo

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S323-S323 ◽  
Author(s):  
Hayley Ashbaugh ◽  
James D Cherry ◽  
Sue Gerber ◽  
Stephen G Higgins ◽  
Adva Gadoth ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Past History ◽  
Positive Control ◽  
P Value ◽  
Republic Of Congo ◽  
History Of ◽  
Long Term Impact ◽  
Induced Immunity

Abstract Background Recent studies suggest a measles-induced immune amnesia that could have long-term immunosuppressive effects via preferential depletion of memory B and T CD150+ lymphocytes. Methods We examined the association between past measles and tetanus antibody levels among children participating in the 2013–2014 Democratic Republic of Congo (DRC) Demographic and Health Survey (DHS). Our sample consisted of 833 children aged 6–59 months whose mothers were selected for interview. Mothers reported (via recall) history of measles within the lifetime of the child. Classification of children who previously had measles was completed using maternal recall and measles immunoglobulin G (IgG) serostatus obtained via dried blood spot (DBS) analysis. A multiplex chemiluminescent immunoassay platform was used to obtain serologic results and Assay Score (AS) was calculated as a ratio to a positive control included in each run. Tetanus serostatus was categorized as being above or below the sample median serology AS value. Tetanus vaccination status was obtained via dated vaccination card and limited to children receiving the complete 3-dose vaccination series. Results The median AS for tetanus serology among the entire sample of 833 children was 0.085, while children with history of measles had a median AS of 0.053 (N = 41) and children with no history of measles had a median AS of 0.088 (N = 792), chi-square P-value &lt; 0.05. A random intercept logistic regression model was used to examine the association between previous measles disease and odds of having below median levels of tetanus antibody. Controlling for potential confounding variables, the odds of a child with past history of measles having less than the median level of tetanus antibody was 3.86 (95% CI: 1.70, 8.78) among children fully vaccinated for tetanus. Conclusion The results suggest that, among children 6–59 months in DRC, measles may have a long-term impact on levels of pre-existing, vaccine-induced immunity to tetanus. These findings suggest the need for laboratory studies examining measles’ impact on pre-existing, vaccine-induced immunity and underscore the need for continued evaluation and improvement of DRC’s measles vaccination program. Disclosures All authors: No reported disclosures.

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