ORCID Profile
0000-0003-0790-5200
Current Organisation
Deakin University
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Publisher: Springer Science and Business Media LLC
Date: 30-07-2021
DOI: 10.1186/S42494-021-00051-3
Abstract: Despite the increasing number of anti-seizure medications becoming available, the proportion of patients with drug-resistant epilepsy remains unchanged. Dietary therapy for epilepsy is well-established practice in paediatric care, but relatively underutilised in adults. Recently, international recommendations have been published to guide the treatment of adults receiving dietary therapy for epilepsy. This review focuses on the specific aspects of care unique to the management of adults receiving dietary therapy for epilepsy, including patient selection, diet composition, initiation, monitoring and cessation of dietary treatment. We emphasise the need for a multidisciplinary team approach with appropriately trained neurologists and dietitians to provide holistic care while the patients are receiving dietary therapy. Future research should focus on the optimal diet composition and meeting the psychosocial needs of adults with epilepsy to maximise efficacy and adherence to dietary treatment.
Publisher: Wiley
Date: 12-04-2020
DOI: 10.1002/EPI4.12391
Publisher: Wiley
Date: 22-02-2019
DOI: 10.1002/EPI4.12308
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 30-10-2020
DOI: 10.1212/CPJ.0000000000001009
Abstract: Ketogenic diet therapy can be used as an adjuvant treatment of super-refractory status epilepticus (SRSE). However, the drug and metabolic interactions with concomitant treatments present a challenge for clinicians. In this review, we focus on the practical considerations of implementing ketogenic dietary therapy in the acute setting, including the dietary composition, potential drug-diet interactions, and monitoring during ketogenic treatment. This report describes the ketogenic diet therapy protocol implemented for the treatment of SRSE and a review of the current evidence to support clinical practice. The control of SRSE is critical in reducing morbidity and mortality. There is emerging evidence that ketogenic diet may be a safe and effective treatment option for these patients.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Wiley
Date: 07-04-2022
DOI: 10.1002/JPEN.2373
Abstract: Induction of ketosis by manipulation of nutrition intake has been proposed as an adjunctive treatment for super‐refractory status epilepticus (SRSE). However, the classical 4:1 ketogenic ratio may not meet the nutrition needs, specifically protein for critically ill adults. The aim of this study was to analyze the outcomes of adults with SRSE who received a lower ketogenic ratio of 2:1 grams of fat to non‐fat grams, including 20%–30% of energy from medium chain triglycerides. We reviewed patients aged ≥18 years with SRSE treated with ketogenic therapy between July 2015 and December 2020 at two quaternary teaching hospitals in Melbourne, Australia. Data collected from medical records included patient demographics, nutrition prescription, clinical outcomes, and ketogenic therapy‐related complications. The primary outcome of the study was to assess tolerability of ketogenic therapy. Twelve patients (female = 7) were treated with ketogenic therapy for SRSE. Patients received between 4 and 8 antiseizure medications and 1–5 anesthetic agents prior to commencement of ketogenic therapy. Blood beta‐hydroxybutyrate concentrations were variable (median = 0.5 mmol/L, range: 0.0–6.1 mmol/L). SRSE resolved in 10 cases (83%) after a median of 9 days (range: 2–21 days) following commencement of ketogenic therapy. Ketogenic therapy–associated complications were reported in five patients, leading to cessation in two patients. Despite the challenge in maintaining ketosis during critical illness, low ratio 2:1 ketogenic therapy incorporating medium chain triglycerides is tolerable for adults with SRSE. Further studies are required to determine the optimal timing, nutrition prescription and duration of ketogenic therapy for SRSE treatment.
Start Date: Start date not available
End Date: End date not available
Funder: Royal Melbourne Hospital
View Funded ActivityStart Date: 2017
End Date: 2018
Funder: National Health and Medical Research Council
View Funded Activity