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العنوان
Compliance and ketones levels in Relation to Seizure Control in Children with Drug Resistant Epilepsy Treated with Ketogenic Diet /
المؤلف
Mohammed, Tasneem Mohammed.
هيئة الاعداد
باحث / تسنيم محمد محمد عبدالعال
مشرف / حامد محمود شتلة
مشرف / ياسمين جمال الجندى
مشرف / منة الله أسامة شطا
مشرف / هيا عصام ابراهيم
تاريخ النشر
2022.
عدد الصفحات
162p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
طب الأطفال ، الفترة المحيطة بالولادة وصحة الطفل
تاريخ الإجازة
1/1/2022
مكان الإجازة
جامعة عين شمس - كلية الطب - طب الاطفال
الفهرس
Only 14 pages are availabe for public view

from 162

from 162

Abstract

SUMMARY
D
rug-resistant epilepsy may be defined by International League Against Epilepsy (ILAE)as failure of adequate trials of two tolerated and appropriately chosen and used AED schedules (whether as monotherapies or in combination) to achieve sustained seizure freedom.
The ketogenic diet (KD) is a high-fat, adequate-protein, low-carbohydrate diet. As a special formula diet, the KD provides daily nutrition needs for children, meanwhile controls seizure and decreases the use of antiepileptic drugs; therefore, children actually benefit a lot from this dietary therapy. The most conspicuous metabolic change induced by a ketogenic diet is elevated blood ketone levels
In this study we aimed to evaluate patient`s compliance to ketogenic diet which will be measured by 24-hour dietary assessment and ketones level in blood and urine. Also to determine correlation between patient`s compliance to ketogenic diet as well as ketones level in blood and urine and seizure control in children with drug resistant epilepsy (DRE) on KD.
We studied 42 children of age group 0-18 years diagnosed as drug resistant epilepsy (DRE) on ketogenic diet for at least 3 months, who had been selected from Ketogenic Diet Clinic, Children’s hospital, Ain Shams University, Cairo, Egypt.
All the included patients were subjected to:
Full history taking, Examination including Anthropometric measurements (body weight, length or height, BMI and z-scores), neurological examination, Investigations as BHB in blood, acetone in urine, Serum lipid profile (cholesterol, triglyceride, LDL, HDL), random blood sugar, neuroimaging.
Regarding ketone body levels in blood and urine, Beta hydroxybutarate levels in blood achievd ketosis in 35 patient (>2 mmol) while 37 patient had acetone in urine.
Concerning lipid profile of the patients (cholesterol, triglycerides, high density lipoproteins and low density lipoproteins, there was significant increase in cholesterol levels while there was no significant difference in the rest of lipid profile before and after ketogenic diet.
The patients were compared before and after ketogenic diet administration as regards frequency of convulsions per day and the severity of convulsions using Chalfont severity scale.
As regard frequency of convulsions per day there was highly significant decrease after 3 month of KD with P-value p <0.001 compared to before the diet.
On applying Chalfont seizure severity scale on our patients there was highly significant decrease in the severity of the seizure with P-value p <0.001 after KD.
Regarding to KD, we found about 38 out of 42 patients (90.5%) were compliant to diet. Compliance to KD was determined by using 24-hour dietary recall, acetone in urine and seizure control.
In the current study, there was highly significant correlation between levels of Beta hydroxybutarate in the blood and fat to (protein and carbohydrate) ratio.
Regarding the frequency of complications for the diet in our patients 26.2% complained of constipation, 26.2% complained of Hyperlipidemia,2.4 % complained of vomiting, 2.4 % complained of Kidney stones, 2.4 % complained of Urinary gravels and 2.4 complained of vomiting.