Zastosowanie diety ketogennej w leczeniu padaczki

• Authors: Karol Jastrzębski

Title variants

EN

Ketogenic diet for epilepsy

• Languages of publication: PL

Abstracts

PL

Padaczka jest drugą co do częstości chorobą przewlekłą, z  jaką neurolog spotyka  się w  codziennej praktyce. Niesatysfakcjonująca odpowiedź na leki przeciwpadaczkowe może mieć wiele przyczyn, a część z nich jest potencjalnie modyfikowalna. Dla osób nieodpowiadających na leki w różnych kombinacjach i dawkach opcją terapeutyczną pozostaje usunięcie ogniska padaczkorodnego czy stymulacja nerwu błędnego, jednak nie wszyscy pacjenci z padaczką lekooporną kwalifikują się do wymienionych procedur. Jedną z niefarmakologicznych metod, które można wówczas zastosować, jest dieta ketogenna. Wieloletnie doświadczenia, sięgające lat 20. XX wieku, doprowadziły do zidentyfikowania chorób, w których dieta ketogenna stanowi metodę z wyboru. W przypadku szeroko pojętej padaczki lekoopornej u dzieci i coraz częściej u dorosłych wspomnianą dietę stosuje się nierzadko jako terapię dodaną do już przyjmowanych przez pacjenta leków. Najwięcej dostępnych danych odnosi się do populacji dzieci. Celem pracy był przegląd danych literaturowych na temat padaczki lekoopornej i diety ketogennej. Omówiono jej zastosowanie w związku z deficytem transportera glukozy typu pierwszego, zespołem Dravet, stwardnieniem guzowatym, zespołem Doose’a, zespołem Lennoxa–Gastauta oraz innymi problemami neurologicznymi: zespołem Ohtahary, zespołem Landaua–Kleffnera i encefalopatią padaczkową z ciągłymi wyładowaniami typu iglica–fala w trakcie snu. Dane z piśmiennictwa wskazują, że dieta ketogenna jest skuteczną pozafarmakologiczną metodą leczenia. Co ważne, często powinno się ją wdrażać nie na samym końcu, lecz na wcześniejszych etapach postępowania.

EN

Epilepsy is the second most frequent chronic condition neurologists encounter in their day-to-day practice. Suboptimal response to antiepileptic drugs may be due to numerous factors, some of which may be modified. For patients who remain nonresponsive to various combinations of drugs and doses, the therapeutic options include surgery, or vagal nerve stimulation, yet not all patients with drug-resistant epilepsy are eligible for the procedures. Ketogenic diet is one of the available non-pharmacological options in such cases. Many years of experience, dating back to the 1920s, have allowed to identify disorders in which ketogenic diet is the treatment modality of choice. In the case of broadly defined drug-resistant epilepsy in children, and increasingly often in adult patients, ketogenic diet is an established adjunctive treatment. Most of the available data concerns the paediatric population. This paper is a review of literature data regarding ketogenic diet for drug-resistant epilepsy. The diet’s application has been discussed for the management of various neurological disorders such as glucose transporter type 1 deficiency syndrome (GLUT1 deficiency syndrome), Dravet syndrome, tuberous sclerosis, Doose syndrome, Lennox–Gastaut syndrome, Ohtahara syndrome, Landau–Kleffner syndrome and epileptic encephalopathy with continuous spike and wave during sleep. The literature data demonstrate ketogenic diet to be an effective nonpharmacological treatment method. Importantly, however, in many cases instead of being considered a therapy of last resort, it should be offered earlier in the management.

Keywords

EN

dieta ketogenna; encefalopatie padaczkowe; padaczka; padaczka lekooporna; terapia

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Aktualności Neurologiczne
• Year: 2017
• Volume: 17
• Issue: 4
• Pages: 214–219

Contributors

author

Karol Jastrzębski

• Klinika Neurologii i Udarów Mózgu, Uniwersytet Medyczny w Łodzi, Łódź, Polska

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• Document Type: article