Intravenous Ketogenic Diet Therapy for Treatment of the Acute Stage of Super-Refractory Status Epilepticus in a Pediatric Patient

• Published in: Pediatric neurology 2015-04, Vol.52 (4), p.442-445
• Main Authors: Lin, Jainn-Jim, MD, Lin, Kuang-Lin, MD, Chan, Oi-Wa, MD, Hsia, Shao-Hsuan, MD, Wang, Huei-Shyong, MD
• Format: Article
• Language: English
• Subjects: Acute Disease; Administration, Intravenous; Anesthetics, Intravenous - therapeutic use; Child; children; Diet, Ketogenic - adverse effects; Drug Resistant Epilepsy - diet therapy; Humans; intravenous ketogenic diet; ketogenic diet; Ketosis - etiology; Male; Neurology; Pediatrics; refractory status epilepticus; Status Epilepticus - diet therapy; Thiamylal - therapeutic use; Treatment Outcome
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2014.12.008

Abstract Background A ketogenic diet has been used successfully to treat intractable epilepsy. However, the role of early intravenous initiation of ketogenic diet in the acute phase of super-refractory status epilepticus is not well-described. Methods An intravenous ketogenic diet was administered to a boy with super-refractory status epilepticus. At 24 hours after intravenous ketogenic diet, moderate ketosis appeared, and thiamylal was successfully weaned at 70 hours after admission. Results An intravenous ketogenic regimen led to subsequent ketosis and seizure control in a child with super-refractory status epilepticus. Conclusion Early induction of ketosis may be a novel strategy to effectively treat super-refractory status epilepticus. Although there are few data regarding the early use of intravenous ketogenic diet in the treatment of super-refractory status epilepticus, it may be considered an alternative option.