Ketogenic diet therapy for epilepsy during pregnancy: A case series
| Autor: | Coriene E. Catsman-Berrevoets, Johannes J. Duvekot, Mackenzie C. Cervenka, Tanya J. Williams, Joanne F. Olieman, Monique Williams, Marijn J. Vermeulen, Rinze F. Neuteboom, Eric H. Kossoff, Bobbie J. Henry-Barron, Elles J.T.M. van der Louw, Natalja Bannink |
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| Přispěvatelé: | Internal Medicine, Erasmus MC other, Obstetrics & Gynecology, Pediatrics, Neurology |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Blood Glucose medicine.medical_specialty Pediatrics medicine.medical_treatment food.diet Lamotrigine 03 medical and health sciences chemistry.chemical_compound Epilepsy 0302 clinical medicine food Pregnancy Internal medicine Hyperlipidemia medicine Humans 030212 general & internal medicine Medium-chain triglyceride Atkins diet business.industry General Medicine Ketones medicine.disease Endocrinology Neurology chemistry Female Neurology (clinical) Ketosis Diet Ketogenic business 030217 neurology & neurosurgery Ketogenic diet medicine.drug |
| Zdroj: | Seizure, 45, 198-201. W.B. Saunders |
| ISSN: | 1059-1311 |
| DOI: | 10.1016/j.seizure.2016.12.019 |
| Popis: | Purpose Evaluation of ketogenic diet (KD) therapies for seizure control during pregnancy when safety and appropriate management become considerations. Until now, no information has been available on seizure reduction and human pregnancy related outcomes in women treated with KD therapies. Method We describe two cases of pregnant women with epilepsy treated with KD therapy either as monotherapy (Case 1) or as adjunctive therapy (Case 2). Results Case 1: A 27 year old woman, gravida1, started the classic KD with medium chain triglyceride (MCT) emulsion and 75g carbohydrate-restriction, later reduced to 47g. Glucose levels were 4–6mmol/L and blood ketone levels ranged from 0.2 to 1.4mmol/L. Seizure frequency decreased and seizure-free days increased. Mild side effects included intolerance to MCT, reduced serum carnitine and vitamin levels, and mild hyperlipidemia. Fetal and neonatal growth was normal as was growth and development at 12 months. Case 2: A 36 year-old nulliparous woman was treated with a 20 gram carbohydrate-restricted Modified Atkins Diet (MAD) and lamotrigine, resulting in reduction of seizure frequency to once per month prior to pregnancy. Once pregnant, carbohydrates were increased to 30g. When seizures increased, lamotrigine dose was doubled. Urine ketones trended down during second trimester. A male was born with bilateral ear deformities of unknown significance. The child had a normal neurodevelopment at eight months. Conclusion Non-pharmacological epilepsy therapies like KD and MAD may be effective during human pregnancy. However, safety still has to be established. Further monitoring to identify potential long term side effects is warranted. |
| Databáze: | OpenAIRE |
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