Ketogenic diet (KD) in the treatment of encephalopathy with continuous spike and waves during slow s...
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M.J. Miranda , M. Atkins, L. Sahlholdt, T. Hoffmann, H Nielsen, M Mortensen, M.Nikanorova PowerPoint PPT Presentation


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Ketogenic diet (KD) in the treatment of encephalopathy with continuous spike and waves during slow sleep (CSWS): a pilot study. M.J. Miranda , M. Atkins, L. Sahlholdt, T. Hoffmann, H Nielsen, M Mortensen, M.Nikanorova ¹ Danish Epilepsy Centre, Dianalund, Denmark. Introduction

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M.J. Miranda , M. Atkins, L. Sahlholdt, T. Hoffmann, H Nielsen, M Mortensen, M.Nikanorova

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M j miranda m atkins l sahlholdt t hoffmann h nielsen m mortensen m nikanorova

Ketogenic diet (KD) in the treatment of encephalopathy with continuous spike and waves during slow sleep (CSWS): a pilot study

M.J. Miranda, M. Atkins, L. Sahlholdt, T. Hoffmann, H Nielsen, M Mortensen, M.Nikanorova

¹Danish Epilepsy Centre, Dianalund, Denmark

  • Introduction

  • Epilepsy syndromes with continuous spikes and waves during slow sleep (CSWS) are defined as “a cognitive or behavioural impairment acquired during childhood, associated with a strong activation of the interictal epileptiform discharges during non-REM (NREM) sleep”¹

  • Treatment with Antiepileptic drugs (AEDs) as Valproate, Benzodiazepines, Sultiam, Ethosuximide and more recently Levetiracetam² as well as Steroids might be helpful but the effect is often intermittent

  • In a proportion of children, CSWS is resistant to all AEDs with high risk of cognitive deterioration³

  • Aim

  • To evaluate the effectiveness of KD for treating medically refractory CSWS, regarding tolerability, electro-clinical features and cognitive functions.

  • Patients and methods

  • The first 4 patients, fulfilling clinical and

  • electrophysiological criteria4 (at least 85% interictal discharges in NREM sleep) of CSWS are presented.

  • CSWS was refractory to all tried medications

  • Neuropsychological test (WPPSI/ WISC) are available

  • before KD and at follow up

  • 24-hour EEG recording is available before start of KD

  • and at follow up, every 3-6 mo.

EEG from patient 3

EEG

Table 2. Results

*n/a= no available

Table 1. Patient data

  • Results

  • EEG characteristics (% discharges in NREM sleep) seem to

  • fluctuate independently to KD

  • No significant improvement in EEG or cognitive tests were found

  • Conclusions

  • KD does not seem to be effective in the treatment

  • of encephalopathy with CSWS

  • Further studies with more included patients are needed

.

References

¹Van Bogaert P et al,2006 Acta Neurol Belg

²Aeby A et al, 2005 Epilepsia

³ Veggiotti P ,2002 Epileptic Disord.

4 ”Epileptic syndromes in infancy, childhood and adolescence”, 2005,

Ed. Roger M, Wolf P et al.

r

KD characteristics

Classical ketogenic diet with ratios 2.5-4.0: 1 were used with good

acceptance and tolerability

[email protected]

[email protected]


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