الفهرس | Only 14 pages are availabe for public view |
Abstract The most accepted definition for drug resistant epilepsy is failure of adequate trials of 2 tolerated and appropriately chosen and used anti-epileptic drugs (AED) schedules whether as monotherapies or in combination) to achieve sustained seizure freedom. Ketogenic diet is a high-fat, low-carbohydrate, and adequate-protein diet well-established as treatment option for drug resistant childhood epilepsies. Our aim of the current study is to evaluate serum Selenium levels in children receiving KD treatment for intractable seizures for 6 months duration and to verify the efficacy of KD on oxidative stress by evaluation serum MDA and TAC levels. The present study included 90 infants and children with age range from 6 months to 6 years they were sub-divided into 3 groups group I: Thirty patients with drug resistant epilepsy under pharmacological treatments only, group II: Thirty patients with drug resistant epilepsy under treatment with KD for 6 months and other pharmacological treatments group III: Thirty age and sex matched healthy infants and children served as controls. All subjects were not receiving Se containing or antioxidant drugs. Furthermore, all subjects have no chronic or systemic diseases (e.g. cardiac, hepatic, or renal diseases). There was no statistically significant difference between the ages and gender of the groups in the study. All subjects were recruited from Children Hospital Ain Shams University Hospital during the period May 2017 to January 2018. All subjects in the present study was evaluated through full medical history stressing on frequency and severity of seizures for patients, clinical examination with emphasis on neurological examination, anthropometric measures and symptoms of selenium deficiency, and finally laboratory investigations evaluating serum Se, MDA and TAC. As regards frequency and severity of seizures; they were significantly lower in group II receiving KD as a treatment than group I on pharmacological treatment only. Regarding Se levels was noted to be lower in overall epileptic patients in comparison to controls but it was markedly lower in the KD group.For serum MDA levels; it was found to be higher in overall epileptic patients in comparison to controls with a lower value among group of patients receiving treatment with KD compared to refractory epileptic patients on pharmacological treatment only. Regarding Serum TAC levels; it was found to be lower in overall epileptic patients in comparison to controls with a higher value among group of patients receiving treatment with KD compared to refractory epileptic patients on pharmacological treatment only. In summary, KD is an effective treatment for refractory epilepsy for its anti-epileptic mechanism. It also may exert antioxidant effects. The nutrient content of KD may not meet the RDA for Se and so this should be taken in consideration for supplementation of minerals in adequate amounts. |