Use of the ketogenic diet in the neonatal intensive care unit-Safety and tolerability.

Abstract:

:Drug-resistant epilepsy poses a challenge in neonatal patients, especially those in the neonatal intensive care unit (NICU), who have various secondary comorbidities. We present results of four children with a history of drug-resistant epilepsy for whom a ketogenic diet was initiated and used in the NICU. A nonfasting induction into ketosis over 1-2 weeks was utilized, with gradual increases in the ketogenic ratio every 2-3 days. Data were collected retrospectively from a database, which included medical history, daily progress notes, relevant laboratory data, and imaging and diagnostic information. The ketogenic diet was well tolerated in all cases. The most common side effects observed were constipation, hypoglycemia, and weight loss. Serum β-hydroxybutyrate levels demonstrated improved reliability as a marker of ketosis when compared to urine ketones in this population. Perceived benefits to the infants included improved seizure control, increased alertness, and decreased need for invasive respiratory support. These cases demonstrate that the use of the ketogenic diet for treatment of neonatal encephalopathy and refractory epilepsy can be undertaken safely in the NICU and is well tolerated by carefully screened neonates and infants.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Thompson L,Fecske E,Salim M,Hall A

doi

10.1111/epi.13650

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

e36-e39

issue

2

eissn

0013-9580

issn

1528-1167

journal_volume

58

pub_type

杂志文章
  • GABA uptake blocker NNC-711 exhibits marked anticonvulsant action in two cortical epileptic models in immature rats.

    abstract:PURPOSE:To study the anticonvulsant action of a gamma-aminobutyric acid (GABA) uptake inhibitor NNC-711 in two models of cortical epileptogenesis in immature rats. METHODS:Twelve-, 18-, and 25-day-old rat pups with implanted electrodes were used in this study. Epileptogenic foci were elicited by a local application of...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1999.tb00846.x

    authors: Bernásková K,Slamberová R,Mares P

    更新日期:1999-09-01 00:00:00

  • Effect of prolonged anticonvulsant medication in epileptic patients: serum lipids, vitamins B6, B12, and folic acid, proteins, and fine structure of liver.

    abstract::Twenty-seven epileptic patients, most from low socioeconomic groups and aged 15-54 years, were studied for effects of prolonged anticonvulsant medication. They had received the usual doses of phenobarbitone and diphenylhydantoin (PHT) regularly for 3-32 years, with control of seizures, and had not taken any B-vitamins...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1987.tb03641.x

    authors: Dastur DK,Dave UP

    更新日期:1987-03-01 00:00:00

  • Changes in nitric oxide synthesis and epileptic activity in the contralateral hippocampus of rats following intrahippocampal kainate injection.

    abstract:PURPOSE:To investigate the effects of nitric oxide (NO) on seizure activity observed in brain areas that are remote from a primary epileptic focus. METHODS:Following an injection of kainate (concentration 1 mg/ml, volume 1 microl) in the rat hippocampus, we measured NO synthesis in the contralateral hippocampus and ep...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1046/j.1528-1157.2001.083032.x

    authors: Yasuda H,Fujii M,Fujisawa H,Ito H,Suzuki M

    更新日期:2001-01-01 00:00:00

  • Gabapentin as add-on therapy in children with refractory partial seizures: a 12-week, multicentre, double-blind, placebo-controlled study. Gabapentin Paediatric Study Group.

    abstract:PURPOSE:To evaluate the efficacy and safety of gabapentin (Neurontin; GBP) as add-on therapy for refractory partial seizures in paediatric patients aged 3-12 years. METHODS:After a 6-week baseline period, 247 patients (54 centres) entered a 12-week double-blind phase and were randomized to receive either GBP (t.i.d., ...

    journal_title:Epilepsia

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1111/j.1528-1157.1999.tb00833.x

    authors: Appleton R,Fichtner K,LaMoreaux L,Alexander J,Halsall G,Murray G,Garofalo E

    更新日期:1999-08-01 00:00:00

  • Seizure generation: the role of nodes and networks.

    abstract::The longstanding dichotomy between the concepts of "focal" and "primary generalized" epilepsy has become increasingly blurred, raising fundamental questions about the nature of ictal onset in localized brain regions versus large-scale brain networks. We hypothesize that whether an EEG discharge appears focal or genera...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2012.03560.x

    authors: Terry JR,Benjamin O,Richardson MP

    更新日期:2012-09-01 00:00:00

  • Distinction between normal and epileptic rhythms in rodent sensorimotor cortex.

    abstract::Characteristics of spontaneous spindling in electrocorticograms from awake rodents are described. Comparisons are made between this spontaneous activity and epileptic activity generated in the sensorimotor cortex. ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1979.tb04833.x

    authors: Hammond EJ,Villarreal HJ,Wilder BJ

    更新日期:1979-10-01 00:00:00

  • Risk of seizure recurrence after achieving initial seizure freedom on the ketogenic diet.

    abstract:OBJECTIVE:Few studies have examined the long-term sustainability of complete seizure freedom on the ketogenic diet (KD). The purpose of this study was to describe the risk of seizure recurrence in children who achieved at least 1 month of seizure freedom on the KD, and to assess clinical features associated with sustai...

    journal_title:Epilepsia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/epi.12583

    authors: Taub KS,Kessler SK,Bergqvist AG

    更新日期:2014-04-01 00:00:00

  • Clinical features of patients with posterior cortex epilepsies and predictors of surgical outcome.

    abstract:PURPOSE:Posterior cortex epilepsies (PCEs) encompass a group of epilepsies originating from the occipital, parietal, or occipital border of the temporal lobe, or from any combination of these regions. When their seizures are refractory to pharmacologic treatment, these patients are usually referred for surgery. The aim...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2005.70904.x

    authors: Dalmagro CL,Bianchin MM,Velasco TR,Alexandre V Jr,Walz R,Terra-Bustamante VC,Inuzuka LM,Wichert-Ana L,Araújo D Jr,Serafini LN,Carlotti CG Jr,Assirati JA Jr,Machado HR,Santos AC,Sakamoto AC

    更新日期:2005-09-01 00:00:00

  • Insular epilepsy surgery.

    abstract::Since it was originally described nearly 70 years ago, insular epilepsy has been increasingly recognized and may explain failures after apparently well-planned operations. We review the history of awareness of the phenomenon, techniques for its assessment, and its surgical management. Insular epilepsy can mimic featur...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/epi.13682

    authors: Laoprasert P,Ojemann JG,Handler MH

    更新日期:2017-04-01 00:00:00

  • Transient improvement after brief antiepileptic drug withdrawal in the epilepsy monitoring unit--possible relationship to AED tolerance.

    abstract:PURPOSE:A drug holiday seems to produce seizure interval prolongation (SIP) after reinstitution of antiepileptic drugs (AEDs). This effect was demonstrated mainly with carbamazepine. We evaluated SIP with newer AEDs and tested the relationship of SIP to history of AED tolerance. METHODS:We prospectively studied patien...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2009.02494.x

    authors: Azar NJ,Lagrange AH,Wang L,Song Y,Abou-Khalil BW

    更新日期:2010-05-01 00:00:00

  • Characterization of kindled VGAT-Cre mice as a new animal model of temporal lobe epilepsy.

    abstract:OBJECTIVE:Development of novel therapies for temporal lobe epilepsy is hindered by a lack of models suitable for drug screening. While testing the hypothesis that "inhibiting inhibitory neurons" was sufficient to induce seizures, it was discovered that a mild electrical kindling protocol of VGAT-Cre mice led to spontan...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.16651

    authors: Straub J,Gawda A,Ravichandran P,McGrew B,Nylund E,Kang J,Burke C,Vitko I,Scott M,Williamson J,Joshi S,Kapur J,Perez-Reyes E

    更新日期:2020-10-01 00:00:00

  • Validation of a brief screening instrument for the ascertainment of epilepsy.

    abstract:PURPOSE:To validate a brief screening instrument for identifying people with epilepsy in epidemiologic or genetic studies. METHODS:We designed a nine-question screening instrument for epilepsy and administered it by telephone to individuals with medical record-documented epilepsy (lifetime history of >or=2 unprovoked ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2009.02274.x

    authors: Ottman R,Barker-Cummings C,Leibson CL,Vasoli VM,Hauser WA,Buchhalter JR

    更新日期:2010-02-01 00:00:00

  • WONOEP appraisal: optogenetic tools to suppress seizures and explore the mechanisms of epileptogenesis.

    abstract::Optogenetics is a novel technology that combines optics and genetics by optical control of microbial opsins, targeted to living cell membranes. The versatility and the electrophysiologic characteristics of the light-sensitive ion-channels channelrhodopsin-2 (ChR2), halorhodopsin (NpHR), and the light-sensitive proton ...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/epi.12804

    authors: Mantoan Ritter L,Golshani P,Takahashi K,Dufour S,Valiante T,Kokaia M

    更新日期:2014-11-01 00:00:00

  • Prevalence of epilepsy and seizures in the Navajo Nation 1998-2002.

    abstract:PURPOSE:To determine the prevalence of epilepsy and seizures in the Navajo. METHODS:We studied 226,496 Navajo residing in the Navajo Reservation who had at least one medical encounter between October 1, 1998 and September 30, 2002. We ascertained and confirmed cases in two phases. First, we identified patients with In...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2009.02140.x

    authors: Parko K,Thurman DJ

    更新日期:2009-10-01 00:00:00

  • Refractory status epilepticus during pregnancy secondary to cavernous angioma.

    abstract:SUMMARY:First-time seizure and status epilepticus during pregnancy have been previously reported as the initial manifestation of intracranial cavernous hemangioma. We report a woman with no history of seizures who presented with refractory status epilepticus at 10 weeks gestation. Cranial MRI revealed a right frontal c...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2008.01639.x

    authors: Aladdin Y,Gross DW

    更新日期:2008-09-01 00:00:00

  • Effects of clobazam and its active metabolite on GABA-activated currents in rat cerebral neurons in culture.

    abstract:PURPOSE:The antiepileptic effects of clobazam, a 1,5-benzodiazepine, have been well documented in animal experiments and clinical trials. However, the drug's mechanisms of antiepileptic actions are still undetermined. The purpose of this study was to learn how clobazam and its active metabolite modulate gamma-aminobuty...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1996.tb00643.x

    authors: Nakamura F,Suzuki S,Nishimura S,Yagi K,Seino M

    更新日期:1996-08-01 00:00:00

  • The interaction between sleep and epilepsy.

    abstract::Sleep and epilepsy are interrelated. Understanding the relationship between epilepsy and sleep is important for optimizing management of the epilepsy patient in several ways. First, sleep modulates the expression of epileptic seizures and interictal epileptiform discharges. Second, epilepsy and its treatment influence...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1528-1167.2007.01400.x

    authors: Malow BA

    更新日期:2007-01-01 00:00:00

  • The HLA-A*2402/Cw*0102 haplotype is associated with lamotrigine-induced maculopapular eruption in the Korean population.

    abstract::The use of lamotrigine (LTG) can be limited by the occurrence of cutaneous adverse drug reactions (cADRs) that range from maculopapular eruption (MPE) to the more severe Stevens-Johnson syndrome and toxic epidermal necrolysis. A few human leukocyte antigen (HLA)-related genetic risk factors for carbamazepine-induced c...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.13087

    authors: Moon J,Park HK,Chu K,Sunwoo JS,Byun JI,Lim JA,Kim TJ,Shin JW,Lee ST,Jung KH,Jung KY,Jeon D,Kim DW,Yu KS,Jang IJ,Kang HR,Park HW,Lee SK

    更新日期:2015-10-01 00:00:00

  • Course and outcome of childhood epilepsy: a 15-year follow-up of the Dutch Study of Epilepsy in Childhood.

    abstract:PURPOSE:To study the course and outcome of childhood-onset epilepsy during 15-year follow-up (FU). METHODS:We extended FU in 413 of 494 children with new-onset epilepsy recruited in a previously described prospective hospital-based study by questionnaire. RESULTS:Mean FU was 14.8 years (range 11.6-17.5 years). Five-y...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2010.02546.x

    authors: Geerts A,Arts WF,Stroink H,Peeters E,Brouwer O,Peters B,Laan L,van Donselaar C

    更新日期:2010-07-01 00:00:00

  • Cellular mechanisms of cobalt-induced hippocampal epileptiform discharges.

    abstract:PURPOSE:To explore the cellular mechanisms of cobalt-induced epileptiform discharges in mouse hippocampal slices. METHODS:Hippocampal slices were prepared from adult mice and briefly exposed to a CoCl(2)-containing external solution. Population and single cell activities were examined via extracellular and whole-cell ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2008.01767.x

    authors: He J,Hsiang HL,Wu C,Mylvagnanam S,Carlen PL,Zhang L

    更新日期:2009-01-01 00:00:00

  • Models and mechanisms of experimental epilepsies.

    abstract:PURPOSE:To review the value of experimental models of epilepsy to help us understand the underlying basic neuronal mechanisms. METHODS:The methods addressed here include a variety of acute and chronic experimental epilepsies and their investigation in vitro, in vivo, and in computer simulations. RESULTS:Epileptic dis...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/j.0013-9580.2003.12004.x

    authors: Jefferys JG

    更新日期:2003-01-01 00:00:00

  • Surgical versus medical treatment for epilepsy. I. Outcome related to survival, seizures, and neurologic deficit.

    abstract::We conducted a retrospective parallel longitudinal cohort study comparing surgical and medical treatment for epilepsy. The surgical group contained 201 patients treated with resective surgery for epilepsy in Norway since the first operation in 1949 until January 1988. The 185 control group patients treated medically o...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1991.tb04666.x

    authors: Guldvog B,Løyning Y,Hauglie-Hanssen E,Flood S,Bjørnaes H

    更新日期:1991-05-01 00:00:00

  • Spike wave location and density disturb sleep slow waves in patients with CSWS (continuous spike waves during sleep).

    abstract:OBJECTIVE:In CSWS (continuous spike waves during sleep) activation of spike waves during slow wave sleep has been causally linked to neuropsychological deficits, but the pathophysiologic mechanisms are still unknown. In healthy subjects, the overnight decrease of the slope of slow waves in NREM (non-rapid eye movement)...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.12576

    authors: Bölsterli Heinzle BK,Fattinger S,Kurth S,Lebourgeois MK,Ringli M,Bast T,Critelli H,Schmitt B,Huber R

    更新日期:2014-04-01 00:00:00

  • PACES in epilepsy: Results of a self-management randomized controlled trial.

    abstract:OBJECTIVE:Self-management challenges facing adults with epilepsy include limited understanding of the condition and treatment, associated psychosocial issues, and lack of community integration. Self-management interventions improve patients' medical, life role, and emotional management. Previous interventions, develope...

    journal_title:Epilepsia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/epi.13052

    authors: Fraser RT,Johnson EK,Lashley S,Barber J,Chaytor N,Miller JW,Ciechanowski P,Temkin N,Caylor L

    更新日期:2015-08-01 00:00:00

  • The management of refractory idiopathic epilepsies.

    abstract::Idiopathic epilepsies comprise a wide variety of partial and generalized syndromes that have in common a known or presumed genetic etiology and the lack of overt abnormalities other than the epilepsy itself. Most of these epilepsies have a benign natural history and/or show a favorable response to antiepileptic drug (...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1046/j.1528-1157.2001.042suppl.3031.x

    authors: Perucca E

    更新日期:2001-01-01 00:00:00

  • Excitatory action of GABA on immature neurons is not due to absence of ketone bodies metabolites or other energy substrates.

    abstract::Brain slices incubated with glucose have provided most of our knowledge on cellular, synaptic, and network driven mechanisms. It has been recently suggested that γ-aminobutyric acid (GABA) excites neonatal neurons in conventional glucose-perfused slices but not when ketone bodies metabolites, pyruvate, and/or lactate ...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1528-1167.2011.03132.x

    authors: Ben-Ari Y,Tyzio R,Nehlig A

    更新日期:2011-09-01 00:00:00

  • Localization of lesions by neuropsychological testing.

    abstract::Neuropsychological evaluation differs from other methods used to localize cerebral lesions in that it analyzes cognitive function. Tests sample widely among cognitive abilities, contrasting language proficiency with visuospatial skills. A thorough assessment of memory is crucial in the investigation because of the pro...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:

    authors: Jones-Gotman M

    更新日期:1991-01-01 00:00:00

  • Predicting frequent emergency department use among children with epilepsy: A retrospective cohort study using electronic health data from 2 centers.

    abstract:OBJECTIVE:Among children with epilepsy, to develop and evaluate a model to predict emergency department (ED) use, an indicator of poor disease control and/or poor access to care. METHODS:We used electronic health record data from 2013 to predict ED use in 2014 at 2 centers, benchmarking predictive performance against ...

    journal_title:Epilepsia

    pub_type: 杂志文章,多中心研究

    doi:10.1111/epi.13948

    authors: Grinspan ZM,Patel AD,Hafeez B,Abramson EL,Kern LM

    更新日期:2018-01-01 00:00:00

  • Behavioral and histopathological analysis of domoic Acid administration in marmosets.

    abstract:PURPOSE:To induce status epilepticus (SE) followed by the subsequent onset of spontaneous recurrent seizures, thus characterizing a new model of temporal lobe epilepsy in a nonhuman primate. METHODS:Male and female marmosets (Callithrix jacchus) (n = 18), ages between 2 and 8 years, were injected with domoic acid (0.5...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2005.01023.x

    authors: Perez-Mendes P,Cinini SM,Medeiros MA,Tufik S,Mello LE

    更新日期:2005-01-01 00:00:00

  • The impact of nonadherence to antiseizure drugs on seizure outcomes in an animal model of epilepsy.

    abstract:OBJECTIVE:Nonadherence to prescribed dosing regimens is a significant problem in the treatment of pediatric and adult chronic epilepsy, and can result in severe consequences to patient outcomes. In this first-of-kind preclinical study, the impact of nonadherence on seizure control was studied by simulating human patter...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.13742

    authors: Thomson KE,Modi AC,Glauser TA,Rausch JR,Steve White H

    更新日期:2017-06-01 00:00:00