生酮饮食治疗儿童超难治性癫痫持续状态1例并文献复习  

Ketogenic diet in the treatment of super refractory status epilepticus in children:a case report and literature review

作　　者：宁俊杰 陈华友[1] 官晓艳[1] 李雪梅[1] NING Jun-jie;CHEN Hua-you;GUAN Xiao-yan;LI Xue-mei(First People′s Hospital of Zigong City,Zigong 643000,China)

机构地区：[1]四川省自贡市第一人民医院,四川自贡643000

出　　处：《实用药物与临床》2020年第11期997-1000,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的总结1例超难治性癫痫持续状态儿童的临床特点及诊治过程并进行文献复习。方法回顾性分析1例超难治性癫痫持续状态患儿的临床诊疗过程,并复习国内外相关文献报道。结果患儿入院后予以咪达唑仑、丙戊酸钠、卡马西平止惊,甲强龙冲击治疗,但仍反复抽搐,第6天启动生酮饮食疗法后病情明显好转。结论生酮饮食可能是治疗儿童超难治性癫痫持续状态的有效措施,但目前存在许多技术难度,例如如何为患儿提供及选择食物、何时加用生酮饮食、缺乏具有生酮饮食管理经验的营养师以及如何监测生酮不良反应等;生酮饮食的最佳方案未确定,需要更多的循证证据明确超难治性癫痫持续状态生酮治疗的有效性、安全性及耐受性。Objective To summarize the clinical characteristics,diagnosis and treatment process of a child with super refractory status epilepticus and to review the literature.Methods A retrospective analysis of the clinical diagnosis and treatment of a child with super refractory status epilepticus was made,and relevant domestic and foreign literature was reviewed.Results The child was given midazolam,sodium valproate,carbamazepine and intravenous methylprednisolone pulse to stop the convulsions after admission,but he still had repeated convulsion.The child′s condition was improved significantly after the ketogenic diet was started on the 6th day.Conclusion Ketogenic diet may be an effective measure to treat super refractory status epilepticus in children,but there are many technical difficulties,such as how to provide and choose food for children,when to add ketogenic diet,lack of experienced dietitian in ketogenic diet management and how to monitor adverse effects of ketogenic,etc.Optimal plan for ketogenic diet has not been determined,more evidence-based evidence is needed to clarify the efficacy,safety and tolerability of ketogenic therapy for super refractory status epilepticus.

关 键 词：生酮饮食 超难治性癫痫持续状态 儿童 文献复习 

分 类 号：R742.1[医药卫生—神经病学与精神病学]