DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20213173

Role of dietary therapy in managing epilepsy in children

Mohammed Saeed Babonji, Zahra Abdullah Alkhatir, Adel Abed Alharbi, Buthaynah Abdullah Alghasham, Ola Lateef Abumansour, Majed Hassan Ali, Walaa Mohamed Ali, Nermeen Nasser Alrajhi, Abdulaziz Ali Al Mohammed, Mutasim Hassan Alhasani, Saad Shaker Algethami, Salah Mohammed Alzanbagi

Abstract


Ketogenic diets have been proposed as effective management approaches that have been validated by many studies in the literature. The efficacy of administering these treatment modalities has been validated by many studies within epilepsy-related syndromes as Rett syndrome, infantile spasms, GLUT-1 deficiency and Dravet syndrome. As a result, it has been noticed that observable favorable outcomes within the first three months from starting the administration of these treatment regimens. In this literature review, we have discussed the dietary therapeutic approaches for managing epilepsy in children. The findings have been combined from different studies in the literature. Many of them are comparative investigations that have indicated the efficacy of these treatment plans in reducing both the frequency of seizures and adequately inhibiting the development of further epilepsy events. Many mechanisms have been proposed for these treatment modalities to inhibit seizures that are adequately discussed in this article. Based on the current evidence, further awareness approaches should be conducted to increase the administration of these products, especially in pharmaco-resistant cases.


Keywords


Epilepsy, Management, Alternative medicine, Ketogenic diet, Pediatrics

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References


Golyala A, Kwan P. Drug development for refractory epilepsy: The past 25 years and beyond. Seizure. 2017;44:147-56.

Kwan P, Schachter S, Brodie M. Drug-Resistant Epilepsy. New England J Med. 2011;365:919-26.

Sirven JI, Drazkowski JF, Zimmerman RS, Bortz JJ, Shulman DL, Macleish M. Complementary/alternative medicine for epilepsy in Arizona. Neurology. 2003;61(4):576-7.

Eun SH, Kang HC, Kim DW, Kim HD. Ketogenic diet for treatment of infantile spasms. Brain Dev. 2006;28(9):566-71.

Liebhaber GM, Riemann E, Baumeister FA. Ketogenic diet in Rett syndrome. J Child Neurol. 2003;18(1):74-5.

Caraballo RH, Cersosimo RO, Sakr D, Cresta A, Escobal N, Fejerman N. Ketogenic diet in patients with Dravet syndrome. Epilepsia. 2005;46(9):1539-44.

Klepper J, Scheffer H, Leiendecker B, Gertsen E, Binder S, Leferink M, Hertzberg C, et al. Seizure control and acceptance of the ketogenic diet in GLUT1 deficiency syndrome: a 2- to 5-year follow-up of 15 children enrolled prospectively. Neuropediatrics. 2005;36(5):302-8.

Kossoff EH, Kania BA, Rho JM. Ketogenic diets: an update for child neurologists. J Child Neurol. 2009;24(8):979-88.

Powell K, Holt SH, Brand-Miller JC. International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr. 2002;76(1):5-56.

Martin K, Jackson CF, Levy RG, Cooper PN. Ketogenic diet and other dietary treatments for epilepsy. Cochrane Database System Rev. 2016;2:1903.

Neal EG, Chaffe H, Schwartz RH, Lawson MS, Edwards N, Fitzsimmons G, et al. The ketogenic diet for the treatment of childhood epilepsy: a randomised controlled trial. Lancet Neurol. 2008;7(6):500-6.

Sharma S, Sankhyan N, Gulati S, Agarwala A. Use of the modified Atkins diet for treatment of refractory childhood epilepsy: a randomized controlled trial. Epilepsia. 2013;54(3):481-6.

Lambrechts DA, Kinderen RJ, Vles JS, Louw AJ, Aldenkamp AP, Majoie HJ. A randomized controlled trial of the ketogenic diet in refractory childhood epilepsy. Acta Neurol Scand. 2017;135(2):231-9.

Hallbook T, Sjolander A, Amark P, Miranda M, Bjurulf B, Dahlin M. Effectiveness of the ketogenic diet used to treat resistant childhood epilepsy in Scandinavia. Eur J Paediatr Neurol. 2015;19(1):29-36.

Klein P, Tyrlikova I, Mathews GC. Dietary treatment in adults with refractory epilepsy: a review. Neurology. 2014;83(21):1978-85.

Groesbeck DK, Bluml RM, Kossoff EH. Long-term use of the ketogenic diet in the treatment of epilepsy. Dev Med Child Neurol. 2006;48(12):978-81.

Martinez CC, Pyzik PL, Kossoff EH. Discontinuing the ketogenic diet in seizure-free children: recurrence and risk factors. Epilepsia. 2007;48(1):187-90.

Hallbook T, Lundgren J, Rosén I. Ketogenic diet improves sleep quality in children with therapy-resistant epilepsy. Epilepsia. 2007;48(1):59-65.

IJff DM, Postulart D, Lambrechts DAJE, Majoie MHJM, Kinderen RJA, Hendriksen JGM, et al. Cognitive and behavioral impact of the ketogenic diet in children and adolescents with refractory epilepsy: A randomized controlled trial. Epilepsy Behav. 2016;60:153-7.

Mady MA, Kossoff EH, McGregor AL, Wheless JW, Pyzik PL, Freeman JM. The ketogenic diet: adolescents can do it, too. Epilepsia. 2003;44(6):847-51.

Kossoff EH, Kania BA, Amark PE, Gil KR, Christina BAG, Blackford R, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009;50(2):304-17.

Hartman AL, Gasior M, Vining EP, Rogawski MA. The neuropharmacology of the ketogenic diet. Pediatr Neurol. 2007;36(5):281-92.

Yudkoff M, Daikhin Y, Melo TM, Nissim I, Sonnewald U, Nissim I. The ketogenic diet and brain metabolism of amino acids: relationship to the anticonvulsant effect. Annual review of nutrition. 2007;27:415-30.

Dahlin M, Elfving A, Ungerstedt U, Amark P. The ketogenic diet influences the levels of excitatory and inhibitory amino acids in the CSF in children with refractory epilepsy. Epilepsy Res. 2005;64(3):115-25.

Bough K. Energy metabolism as part of the anticonvulsant mechanism of the ketogenic diet. Epilepsia. 2008;49(8):9.

Lima PA, Sampaio LP, Damasceno NR. Neurobiochemical mechanisms of a ketogenic diet in refractory epilepsy. Clinics. 2014;69(10):699-705.

Boison D. New insights into the mechanisms of the ketogenic diet. Current Opinion Neurol. 2017;30(2):187-92.

Simeone TA, Simeone KA, Rho JM. Ketone Bodies as Anti-Seizure Agents. Neurochem Res. 2017;42(7):2011-18.

Ma W, Berg J, Yellen G. Ketogenic diet metabolites reduce firing in central neurons by opening K(ATP) channels. J Neurosci. 2007;27(14):3618-25.

Yellen G. Ketone bodies, glycolysis, and KATP channels in the mechanism of the ketogenic diet. Epilepsia. 2008;49(8):80-2.

Jeong EA, Jeon BT, Shin HJ, Kim N, Lee DH, Kim HJ, et al. Ketogenic diet-induced peroxisome proliferator-activated receptor-γ activation decreases neuroinflammation in the mouse hippocampus after kainic acid-induced seizures. Exp Neurol. 2011;232(2):195-202.

Donald TJW, Cervenka MC. Ketogenic Diets for Adult Neurological Disorders. Neurotherapeutics. 2018;15(4):1018-31.

Knowles S, Budney S, Deodhar M, Matthews SA, Simeone KA, Simeone TA. Ketogenic diet regulates the antioxidant catalase via the transcription factor PPARγ2. Epilepsy Res. 2018;147:71-4.

Chang P, Augustin K, Boddum K, Williams S, Sun M, Terschak JA, et al. Seizure control by decanoic acid through direct AMPA receptor inhibition. Brain. 2016;139(2):431-43.