摘要
目的探讨生酮饮食(ketogenic diet,KD)添加治疗儿童难治性癫癎的临床疗效、脑电图变化及对认知功能的影响。方法研究对象为2012年8月至2013年8月接受KD添加治疗的20例难治性癫癎患儿。KD治疗方案为启动时禁食,脂肪和蛋白质、碳水化合物比例逐渐增高至4:1。疗效评估方法以KD添加治疗前癫癎发作频率为基线,通过家长的癫癎日记,记录发作的频率、类型及程度的变化,并于添加KD前、添加KD后3、6、9个月分别行24 h视频脑电图检查、Gesell发育量表评定。结果 20例患儿中,临床控制无发作6人,完全控制率为30%;有效13人,总有效率为65%。脑电图改善8人,总有效率为40%;Gesell发育量表评定6人提高一个等级,改善率为30%,改善能区主要在大运动及适应性能区。KD治疗不良反应轻微。结论 KD治疗儿童难治性癫癎安全有效;KD治疗后脑电图改变与临床疗效有一定相关性,且对认知功能有一定改善。
Objective To study the clinical efficiency, electroencephalogram (EEG) changes and cognitive improvements of ketogenic diet (KD) in children with refractory epilepsy. Methods Twenty pediatric patients (7-61 months in age) with refractory epilepsy were recruited between August 2012 and August 2013. KD therapy was performed on all participants for at least 3 months based on a fasting initiation protocol with the lipid-to-nonlipid ratio being gradually increased to 4:1. Seizure frequency, type and degree were recorded before and during KD therapy. A 24 hours video-electroencephalogram (V-EEG) examination and Gesell Developmental Scale assessment were performed prior to KD therapy, and 3, 6, 9 months after KD therapy. Results Six patients became seizure free after KD therapy, with a complete control rate of 30%. Seizure frequency reduction occurred in 13 (65%) patients, EEG improvement in 8 (40%) patients, and improvement in Gesell Developmental Scales (gross motor and adaptability in particular) in 6 (30%) patients. The KD therapy-related side effects were mild. Conclusions KD therapy is safety and effective in reducing seizure frequency and improving EEG and cognitive function in children with refractory epilepsy.
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2014年第5期513-517,共5页
Chinese Journal of Contemporary Pediatrics
关键词
难治性癫痫
生酮饮食
认知功能
视频脑电图
儿童
Refractory epilepsy
Ketogenic diet
Cognitive function
Video-electroencephalogram
Child