Pediatric to Adult Transitions of Ketogenic Dietary Therapy for Epilepsy.

Abstract:

:Ketogenic therapy is now an accepted treatment for pediatric and adult patients with medically refractory epilepsy.1-3 However, young adults treated with a ketogenic diet face unique challenges when transitioning to adult neurology providers.4 The variable acceptance of dietary therapy, paucity of nutritionists and adult neurology providers educated in dietary therapy, and lack of insurance coverage for dietary education may interfere with transition to adult care. In addition, patients in this life stage may just begin to independently seek medical care, cook meals, and manage medications, making strict dietary limitations difficult.4 In this worldwide study, we surveyed 191 pediatric and adult neurology providers who prescribe ketogenic dietary therapy for epilepsy. Our response rate was 39% with a total of 74 valid surveys received. Our goal was to identify perceived barriers that inhibit effective transition and successful continuation of dietary therapy during transition to adult care. We found that dietary therapy is a more accepted treatment of intractable epilepsy in children (84%) than adults (17%) in all geographic areas. Although half of pediatric neurology providers (50%) transition their young adult patients on dietary therapy to adult providers, only 23% have a documented transition plan or a formal transition protocol. Most (87%) pediatric providers who prescribe the ketogenic diet feel the lack of sufficient adult providers who prescribe dietary therapy as a barrier to transitioning adolescent and young adult patients.

journal_name

J Child Neurol

authors

Seaborg K,Wang X,Olson C,Felton EA

doi

10.1177/0883073820938587

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

896-900

issue

13

eissn

0883-0738

issn

1708-8283

journal_volume

35

pub_type

杂志文章
  • Plasma baclofen levels in children receiving continuous intrathecal baclofen infusion.

    abstract::To determine the plasma baclofen concentrations of children undergoing continuous intrathecal baclofen infusion for treatment of cerebral spasticity, we assayed plasma samples from six children, 8 to 18 years of age, who were receiving intrathecal baclofen at constant rates of 77 to 400 micrograms/day. Plasma levels w...

    journal_title:Journal of child neurology

    pub_type: 临床试验,杂志文章

    doi:10.1177/088307389901400611

    authors: Albright AL,Shultz BL

    更新日期:1999-06-01 00:00:00

  • Acute infantile bilateral striatal necrosis: single-photon emission computed tomography (SPECT) imaging and review.

    abstract::Acute infantile bilateral striatal necrosis is a rarely described acute neurological syndrome associated with radiological findings. Its etiology and pathogenic mechanisms are unknown. Clinically, the syndrome usually follows respiratory illnesses and presents with an array of neurological findings, including axial at...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/0883073807304194

    authors: Zevit N,Steinmetz A,Kornreich L,Straussberg R

    更新日期:2007-10-01 00:00:00

  • Brain diffusivity in infants with hypoxic-ischemic encephalopathy following whole body hypothermia: preliminary results.

    abstract::Hypoxic-ischemic encephalopathy is an important cause of neuropsychological deficits. Little is known about brain diffusivity in these infants following cooling and its potential in predicting outcome. Diffusion tensor imaging was applied to 3 groups: (1) three infants with hypoxic-ischemic encephalopathy: cooled; (2)...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/0883073811402346

    authors: Artzi M,Sira LB,Bassan H,Gross-Tsur V,Berger I,Marom R,Leitner Y,Bental Y,Shiff Y,Geva R,Weinstein M,Bashat DB

    更新日期:2011-10-01 00:00:00

  • Autonomic dysfunction in childhood Guillain-Barré syndrome.

    abstract::This investigation correlated incidence and degree of autonomic dysfunction with the degree of motor impairment in children hospitalized with Guillain-Barré syndrome. Motor weakness varies, as does the effect on autonomic function including heart rate, vasomotor stability, sweating, continence, and blood pressure. Aft...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/0883073811420872

    authors: Dimario FJ Jr,Edwards C

    更新日期:2012-05-01 00:00:00

  • Accessory brains (extracerebral heterotopias): unusual prenatal intracranial mass lesions.

    abstract::Prenatal ultrasonographic evidence of intracranial mass lesions generally results in a diagnosis of primary glial or primitive neuroectodermal neoplasm. We describe two infants, one who was stillborn at 25 weeks' estimated gestational age and one term infant who was born live and died shortly after birth with large in...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/088307389400900410

    authors: Harris CP,Townsend JJ,Klatt EC

    更新日期:1994-10-01 00:00:00

  • Autopsy case of later-onset pontocerebellar hypoplasia type 1: pontine atrophy and pyramidal tract involvement.

    abstract::The combination of pontocerebellar hypoplasia and anterior horn cell degeneration is classified as pontocerebellar hypoplasia type 1. Although most cases exhibit severe muscle weakness and hypotonia neonatally with short life spans, some cases exhibit a later onset with a longer life span and show cerebellar atrophy w...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/0883073810372991

    authors: Sanefuji M,Kira R,Matsumoto K,Gondo K,Torisu H,Kawakami H,Iwaki T,Hara T

    更新日期:2010-11-01 00:00:00

  • The Oklahoma City bombing: a personal account.

    abstract::On April 19, 1995, Oklahoma City (and the United States) lost its innocence. Almost all Oklahomans can relate exactly what they were doing either at 9:02 AM that day or when they first learned of the bombing. Of course, the whole world watched the events unfold through around-the-clock television coverage. One of the ...

    journal_title:Journal of child neurology

    pub_type: 传,历史文章,杂志文章

    doi:10.1177/088307389501000510

    authors: Spengler C

    更新日期:1995-09-01 00:00:00

  • NeuroDebian Virtual Machine Deployment Facilitates Trainee-Driven Bedside Neuroimaging Research.

    abstract::Freely available software, derived from the past 2 decades of neuroimaging research, is significantly more flexible for research purposes than presently available clinical tools. Here, we describe and demonstrate the utility of rapidly deployable analysis software to facilitate trainee-driven translational neuroimagin...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/0883073816668113

    authors: Cohen A,Kenney-Jung D,Botha H,Tillema JM

    更新日期:2017-01-01 00:00:00

  • Case report: cytokine and CD4+ T-cell profiles of monozygotic twins with autism and divergent comorbidities and drug treatment.

    abstract::Autism spectrum disorders are neurodevelopmental disorders that are thought to be caused by a gene-by-environment interaction and in which various immune alterations are reported. We investigate CD4(+) T-cell cytokine profiles and subpopulations in 19-year-old monozygotic twins with autism and different comorbidities....

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/0883073814529821

    authors: Magid-Bernstein J,Mahajan K,Lincoln J,Ming X,Rohowsky-Kochan C

    更新日期:2015-03-01 00:00:00

  • Cognitive outcomes following arterial ischemic stroke in infants and children.

    abstract::This study sought to investigate cognitive outcomes following pediatric arterial ischemic stroke and explore predictors. Participants included 36 children with perinatal or childhood arterial ischemic stroke and a comparison group of 15 children with asthma. Outcomes included cognitive ability, executive functions, an...

    journal_title:Journal of child neurology

    pub_type: 杂志文章,多中心研究

    doi:10.1177/0883073813491828

    authors: Hajek CA,Yeates KO,Anderson V,Mackay M,Greenham M,Gomes A,Lo W

    更新日期:2014-07-01 00:00:00

  • High-dose riboflavin for migraine prophylaxis in children: a double-blind, randomized, placebo-controlled trial.

    abstract::This is the first study to evaluate the efficacy of riboflavin for migraine prophylaxis in children. This was a randomized, double-blind study of riboflavin (200 mg daily) versus placebo in 48 children. The primary efficacy measure was the number of patients achieving a 50% or greater reduction in the number of migrai...

    journal_title:Journal of child neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1177/0883073808318053

    authors: MacLennan SC,Wade FM,Forrest KM,Ratanayake PD,Fagan E,Antony J

    更新日期:2008-11-01 00:00:00

  • Vigabatrin in refractory epilepsy in adults and its application in children.

    abstract::Vigabatrin has been studied in adult drug-resistant epilepsy since 1982 in single-blind and double-blind studies followed by long-term, open evaluations. These studies have provided evidence that vigabatrin is a potent and well-tolerated antiepileptic drug and support its potential value in pediatric epilepsy. The lac...

    journal_title:Journal of child neurology

    pub_type: 杂志文章,评审

    doi:

    authors: Dam M

    更新日期:1991-01-01 00:00:00

  • Retinoblastoma.

    abstract::Retinoblastoma is the most common primary intraocular malignancy of childhood. It typically presents with leukocoria or strabismus. In later stages of the disease, the child may exhibit proptosis, buphthalmos, or hypopyon. The pathognomonic molecular aberration is a loss of function mutation in the RB1 gene on chromos...

    journal_title:Journal of child neurology

    pub_type: 杂志文章,评审

    doi:10.1177/0883073815587943

    authors: Ortiz MV,Dunkel IJ

    更新日期:2016-02-01 00:00:00

  • Genetic susceptibility to neurodevelopmental disorders.

    abstract::A large body of evidence suggests that genetic factors influence liability to many common neurodevelopmental disorders. Examples include Tourette syndrome, attention-deficit hyperactivity disorder, autism, and dyslexia. Characterization of the genetic component of susceptibility to these conditions at a molecular leve...

    journal_title:Journal of child neurology

    pub_type: 杂志文章,评审

    doi:10.1177/088307389901400310

    authors: Ryan SG

    更新日期:1999-03-01 00:00:00

  • Head circumference, brain weight, and tumor burden.

    abstract::The failure to diagnose an ependymoma at an appropriately early age led to an incomplete excision and a tumor burden too great for radiotherapy to control. The development of normative curves for brain weight correlated with head circumference allowed for the estimates of the extremes of possible growth rates of the t...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/088307388600100311

    authors: Alvord EC Jr

    更新日期:1986-07-01 00:00:00

  • Diurnal Salivary Cortisol and Regression Status in MECP2 Duplication Syndrome.

    abstract::MECP2 duplication syndrome is an X-linked genomic disorder that is characterized by infantile hypotonia, intellectual disability, and recurrent respiratory infections. Regression affects a subset of individuals, and the etiology of regression has yet to be examined. In this study, alterations in the hypothalamus-pitui...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/0883073815585577

    authors: Peters SU,Byiers BJ,Symons FJ

    更新日期:2016-02-01 00:00:00

  • Transient magnetic resonance imaging abnormalities during partial status epilepticus.

    abstract::Magnetic resonance imaging is an important tool in the evaluation of patients with seizures. Frequently, abnormalities are found that lead to further, invasive testing. The first child with transient abnormal findings on magnetic resonance imaging during a time of frequent partial seizures is presented. This lesion di...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/088307389100600209

    authors: Riela AR,Sires BP,Penry JK

    更新日期:1991-04-01 00:00:00

  • Joint Position Sense Testing in Young Children.

    abstract::The standard physical examination evaluation for a proprioception abnormality depends upon the patient's ability to follow directions and respond to the examiner, a skill not yet developed in toddlers. This study demonstrates a new proprioception examination method that may allow for better localization of lesions and...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/0883073818812348

    authors: Gray EM,Tomlison KG,Kileny S,Leber SM

    更新日期:2019-03-01 00:00:00

  • Applying the International Classification of Functioning-Children and Youth Version to Pediatric Neuro-oncology.

    abstract::Given the increased survival rates in patients with pediatric central nervous system tumors, late effects such as treatment- and/or illness-related neurologic sequelae as well as neuropsychological deficits and social difficulties have moved into focus in follow-up care. In order to provide personalized treatment reco...

    journal_title:Journal of child neurology

    pub_type: 杂志文章,评审

    doi:10.1177/0883073816669647

    authors: Pletschko T,Felnhofer A,Schwarzinger A,Weiler L,Slavc I,Leiss U

    更新日期:2017-01-01 00:00:00

  • Olfactory Development, Part 1: Function, From Fetal Perception to Adult Wine-Tasting.

    abstract::Discrimination of odorous molecules in amniotic fluid occur after 30 weeks' gestation; fetuses exhibit differential responses to maternal diet. Olfactory reflexes enable reliable neonatal testing. Olfactory bulbs can be demonstrated reliably by MRI after 30 weeks' gestation, and their hypoplasia or aplasia also docume...

    journal_title:Journal of child neurology

    pub_type: 杂志文章,评审

    doi:10.1177/0883073817690867

    authors: Sarnat HB,Flores-Sarnat L,Wei XC

    更新日期:2017-05-01 00:00:00

  • Levetiracetam in refractory pediatric epilepsy.

    abstract::Levetiracetam, one of the newer-generation antiepilepsy drugs, is not currently approved for use in children. Given its favorable efficacy, pharmacokinetic, and, particularly, safety profile in adults, we felt that it may be a useful antiepilepsy drug for children with refractory epilepsy. We treated 39 patients (mean...

    journal_title:Journal of child neurology

    pub_type: 临床试验,杂志文章

    doi:10.1177/088307380201700603

    authors: Wheless JW,Ng YT

    更新日期:2002-06-01 00:00:00

  • Neuroplastic Sensorimotor Resting State Network Reorganization in Children With Hemiplegic Cerebral Palsy Treated With Constraint-Induced Movement Therapy.

    abstract::Using resting state functional magnetic resonance imaging (MRI), we aim to understand the neurologic basis of improved function in children with hemiplegic cerebral palsy treated with constraint-induced movement therapy. Eleven children including 4 untreated comparison subjects diagnosed with hemiplegic cerebral palsy...

    journal_title:Journal of child neurology

    pub_type: 杂志文章,多中心研究

    doi:10.1177/0883073815588995

    authors: Manning KY,Menon RS,Gorter JW,Mesterman R,Campbell C,Switzer L,Fehlings D

    更新日期:2016-02-01 00:00:00

  • Intracranial tumors in infants.

    abstract::The prognosis in infants with brain tumors has historically been very poor. This study reviews 16 infants under the age of 12 months with brain tumors who presented to our institution between 1988 and 1999. The aim was to describe the clinical presentation, diagnosis, and management of these patients and to establish ...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/088307380401900605

    authors: Young HK,Johnston H

    更新日期:2004-06-01 00:00:00

  • Ischemic stroke in the young: evaluation and age comparison of patients six months to thirty-nine years.

    abstract::Ischemic stroke in the young is uncommon, but we currently evaluate at least one young stroke patient at our institutions each week. We undertook this chart review of strokes in patients between the ages of 6 months and 39 years to review all conditions associated with, and thus possibly contributory to, the stroke. W...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/088307389300800311

    authors: Kerr LM,Anderson DM,Thompson JA,Lyver SM,Call GK

    更新日期:1993-07-01 00:00:00

  • Aiming at neuroblastoma and hitting other worthy targets.

    abstract::Neuroblastoma is, at once, the most common and deadly extracranial solid tumor of childhood. Efforts aimed at targeting the neural characteristics of these tumors have taught us much about neural crest cell biology, apoptosis induction in the nervous system, and neurotrophin receptor signaling and intracellular proces...

    journal_title:Journal of child neurology

    pub_type: 杂志文章,评审

    doi:10.1177/0883073813483173

    authors: Schor NF

    更新日期:2013-06-01 00:00:00

  • Acute Cerebellitis or Postinfectious Cerebellar Ataxia? Clinical and Imaging Features in Acute Cerebellitis.

    abstract::Acute cerebellitis is a rare condition often considered within the group of acute postinfectious cerebellar ataxia despite its distinctive clinical and imaging features. We retrieved clinical, laboratory, and follow-up data of 15 children diagnosed with acute cerebellitis in our department between 2011 and 2019. There...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/0883073820901407

    authors: Yildirim M,Gocmen R,Konuskan B,Parlak S,Yalnizoglu D,Anlar B

    更新日期:2020-05-01 00:00:00

  • Neurologic sequela in a patient with galactosemia potentially mediated by interleukin-11 dysfunction.

    abstract::A 16-year-old galactosemic patient, homozygous for the 5.5-kb gene deletion, suffered severe neurologic regression following streptococcal infection. Since the gene deletion includes the promoter of interleukin-11a receptor involved in neuronal apoptosis, we questioned whether this patient had no interleukin-11a recep...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/0883073814540520

    authors: Winter GN,Ben-Pazi H

    更新日期:2015-06-01 00:00:00

  • Event-related potentials (P300) in primary headache in childhood and adolescence.

    abstract::There is strong evidence for a loss of habituation during cognitive processing in migraine as measured by P300 and contingent negative variation in adults. Event-related potentials evoked by an oddball paradigm have not yet been studied in children and adolescents suffering from different primary headache types. We re...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/088307389801300703

    authors: Evers S,Bauer B,Grotemeyer KH,Kurlemann G,Husstedt IW

    更新日期:1998-07-01 00:00:00

  • Anencephaly in the United States, 1968-1987: the declining incidence among white infants.

    abstract::The ethical issues concerning the use of fetal tissue as a source for organ transplantation has focused interest on anencephaly. For reasons that are not entirely clear, the incidence of anencephaly has been declining. As anencephaly is easily recognized and invariably fatal, mortality figures provide an excellent ref...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/088307389100600403

    authors: Snyder RD,Fakadej AF,Riggs JE

    更新日期:1991-10-01 00:00:00

  • Clinical experience on headache in children: analysis of 92 cases.

    abstract::We analyzed, retrospectively, 92 patients with headache to determine the changes in the order of frequency of causes with the development of neuroimaging studies and its efficacy in the investigation of patients with headache. The type of headache was redefined according to the International Headache Society (IHS) dia...

    journal_title:Journal of child neurology

    pub_type: 杂志文章

    doi:10.1177/088307389801300502

    authors: Aysun S,Yetük M

    更新日期:1998-05-01 00:00:00