Keywords
Epilepsia
Epilepsia refratária
How to Cite
Abstract
Around thousands of people around the world are affected by epilepsy. Epileptic seizures can appear in patients in a focal or generalized way, depending on the level of activity of the pathology. There are several antiepileptic drugs available, however, in some individuals, these drugs cannot control seizures, called refractory epilepsy. As a result, several studies were conducted seeking the best alternative treatment for these people. In this context, the ketogenic diet (KD) stands out, which is based on a high intake of lipids and a low intake of carbohydrates and a moderate intake of proteins and which has significantly improved the lives of patients with refractory epilepsy. This study aimed to carry out a systematic review on the beneficial effects resulting from the use of DC, as a therapy and/or alternative, in the treatment of patients with refractory epilepsy. It was a systematic review, which comprises the scientific method for searching and analyzing articles from a certain area of science. The methodological approach of this study was a survey based on Evidence-Based Practice (EBP). It was carried out in the Scientific Electronic Library Online (SCIELO), Latin American and Caribbean Literature in Health Sciences (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE) databases. Articles in Portuguese and English were selected. The sample comprised the analysis of 40 articles with selection criteria and content analysis, with 10 articles being selected that addressed the topic in question. The variables were presented in the form of a form considering the following information: identification of the authors, objectives of the study and main considerations. Numerous studies demonstrate the positive effects of DC and dietary supplements as adjunctive treatment in various neurological disorders, especially refractory epilepsy. In this context, the present work reports the effectiveness of CD as a treatment for refractory epilepsy, having seen that the benefits of this diet therapy are greater than the complications it presents, and can be considered a therapeutic alternative. However, more studies need to be done.
References
ALBERTI, M. J.; AGUSTINHO, A.; ARGUMEDO, L.; ARMENO, M.; BLANCO, V.; BOUQUET, C.; et al. Recommendations for the clinical management of children with refractory epilepsy receiving the ketogenic diet. Archivos argentinos de pediatria, Buenos Aires, v. 114, n. 1, p. 56-63, fev. 2016.
ARMENK, M.; CARABALLO, R.; VACARENZZA, M.; et al. Consenso nacional sobre dieta cetogénica. Revista de Neurología, Buenos Aires, v. 59, n. 5, p. 213-223, set. 2014.
CERVENKA, M. C.; KOSSOFF, E. H.; Dietary Treatment of Intractable Epilepsy. Continuum, Baltimore, v. 19, n. 3, p. 756-66, jun. 2013.
CLANTON, R. M.; WU, G.; AKABANI, G.; ARAMAYO, R. Control of seizures by ketogenic diet-induced modulation of metabolic pathways. Revista amino acids. Vienna, v. 49, n. 1, p. 1-20, set. 2016.
CHEN W.; Kossoff, E. H. Long-term follow-up of children treated with the modified Atkins diet. Journal of Child Neurology, Baltimore, v. 27, n. 6, p. 754-758, abr.
ERCOLE, F. F.; MELO, L. S.; ALCOFORADO, C. L. G. C. Revisão Integrativa versus Revisão Sistemática. Revista Mineira de Enfermagem, Belo Horizonte, v. 18, n. 1, pág. 1-260, mar. 2014.
DE-LA-TORRE-UGARTE-GUANILO, M. C.; TAKAHASHI, R. F.; BERTOLOZZI, M. R. Revisão sistemática: noções gerais. Revista da escola de enfermagem. São Paulo, vol.45, n.5, pp.1260-1266, jan. 2011.
FISHER, R. S.; ACEVEDO, C.; ARZIMANOGLOU, A.; BOGACZ, A.; CROSS, J. H.; ELGER C. E.; ENGEL J. JR.; FORSGREN L.; FRENCH J. A.; GLYNNM.; HESDORFFER D. C.; LEE B. I.; MATHERN G. W.; MOSHÉ S. L.; PERUCCA E.; SCHEFFER I. E.; TOMSON T.; WATANABE M.; WIEBE S. ILAE oficial report: apractical clinical definitionof epilepsy. Epilepsia. Stanford, v. 55, n. 4, p. 475-82, abr. 2014.
FISHER, R. S.; CROSS, J. H.; FRENCH, J. A.; HIGURASHI, N.; HIRSCH, E.; JANSEN, F. E., et al. Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Position paper of the ILAE. Stanford, v. 58, n. 4, p. 522-530, abr. 2017.
GÜZEL, O.; YILMAZ, U.; UYSAL, U.; ARSLAN, N. The effect of olive oil-based ketogenic diet on serum lipid levels in epileptic children. Neurological Sciences. Milão, v. 37, n. 3, p. 465–470, mar. 2016.
HEO, G.; KIM, S.H.; CHANG, M.J. Effect of ketogenic diet and other dietary therapies on antiepileptic drug concentrations in patients with epilepsy. Journal of Clinical Pharmacy and Therapeutics., Seul, v. 42, n. 6, p. 758– 764, dez. 2017.
KAYYALI, H. R.; LUNIOVA, A.; ABDELMOITY, A. Ketogenic Diet Decreases Emergency Room Visits and Hospitalizations Related to Epilepsy. Epilepsy Research and Treatment, Cidade do Kansas, v. 19, n. 7, p. 1-4, set. 2016.
KOSE, E.; GUZEL, O.; ARSLAN, N. Analysis of hematological parameters in patients treated with ketogenic diet due to drug-resistant epilepsy. Neurological Sciences. Springer-verlag, v. 39, n. 1, p. 85–89, jan. 2018.
LAMBRECHTS D. A. J. E.; KINDEREN R. J. A.; VLES H. S. H.; LOUW A. J.; ALDENKAMP A. P.; MAJOIE, M. J. The MCT-ketogenic diet as a treatment option in refractory childhood epilepsy: A prospective study with 2-year follow-up. Epilepsy Behav, Maastricht, v. 51, p. 261–266, out. 2015.
LIMA P. A.; SAMPAIO L. P. B.; DAMASCENO N. R. T. Neurobiochemical mechanisms of a ketogenic diet in refractory epilepsy. Clinics. São Paulo, v. 69, n. 10, p. 699–705, out. 2014.
LIN, A.; TURNER, Z.; DOERRER, S. C.; STANFIELD, A.; KOSSOFF, E. H.; Complications During Ketogenic Diet Initiation: Prevalence, Treatment, and Influence on Seizure Outcomes. Pediatric Neurology. Baltimore, v. 68 , p. 35-39, mar. 2017
LUAT, A. F.; COYLE, L.; KAMAT, D. The Ketogenic Diet: A Practical Guide for Pediatricians. Pediatric Annals. Michigan, v. 45, n. 12, p. 446-450, dez. 2016.
MARTIN, K.; JACKSON, C. F.; LEVY, R. G. Ketogenic diet and other dietary treatments for epilepsy. Cochrane Database Systematic Reviews, Liverpool, v. 2, n.3, mar. 2014.
PALEOLOGOU, E.; ISMAYILOVA, N.; KINALI, M. Use of the Ketogenic Diet to Treat Intractable Epilepsy in Mitochondrial Disorders. Journal of Clinical Medicine. Londres, v. 6, n. 6, p. 1-14, mai. 2017.
PRADO, M. R. Qualidade de vida em adultos com epilepsia tratados em um centro de referência na cidade do Rio de Janeiro - RJ. 2016. 73 f. Dissertação (Mestrado em neurologia) - Universidade Federal do Estado do Rio de Janeiro, 2016.
PREZIOSO, G.; CARLONE, G.; ZACCARA, G.; VERROTTI, A. Efficacy of ketogenic diet for infantile spasms: A systematic review. Acta Neurologica Scandinavica, Chiati, v. 137, n. 1, p. 4–11, jan. 2018.
REZAEI, S.; ABDURAHMAN, A.A.; SAGHAZADEH, A.; BADV, R.S.; MAHMOUDI, M. Short-term and long-term efficacy of classical ketogenic diet and modified Atkins diet in children and adolescents with epilepsy: A systematic review and meta-analysis. Nutritional Neuroscience, Teerã, v. 22, n. 5, p. 317-334,out. 2017.
RHO, J. M. How does the ketogenic diet induce antiseizure effects?. Neuroscience Letters, Alberta, v. 637, s/n, p. 4-10, jul. 2015.
SAMPAIO L. P. Ketogenic diet for epilepsy treatment. Arquivos de Neuro- Psiquiatria. São Paulo, v. 74, n. 10, p. 842-848, out. 2016.
SAMPAIO, L. P. B. ABC da dieta cetogênica para epilepsia refratária. 1ª edição. Editora DOC Content, Rio de Janeiro, p. 220, 2018.
SCHEFFER, I. E.; BERKOVIC, S.; CAPOVILLA, G.; CONNOLLY, M. B.; FRENCH, J.; GUILHOTO, L.; et al. ILAE classification of the epilepsies : Position paper of the ILAE Commission for Classification and Terminology. Position paper of the ILAE. Melborne, v. 58, n. 4, p. 512– 521, abr. 2017.
SESSA, W; FERRAZ, R. R. N. Dieta low carb como estratégia de manejo na remissão do diabetes mellitus insulinorresistente: síntese de evidências. International Jornal of Health Management Review. São Paulo, v. 5, n. 1, mai. 2019.
SILVA, C. R. A.; CARDOSO, I. S. Z. O.; MACHADO, N. R. Considerações sobre Epilepsia. Sociedade Pediatria do Rio Grande do Sul: Boletim Cientifico, Porto Alegre, v. 2, n. 3, p. 71-76, jan. 2014.
SOUSA, L. M. M.; MARQUES, J. M.; FIRMINO, C. F.; FRADE, F.; VALENTIM, O. S.; ANTUNES, A. V. Modelos de formulação da questão de investigação na Prática Baseada na Evidência. Revista Investigação Enfermagem. S2(23), 31-39, 2018.
THAMMONGKOL, S; VEARS, D. F.; BICKNELL-ROYLE, J; NATION, J.; DRAFFIN, K. ; STEWART, K. G.; SCHEFFER, I. E; MACKAY, M. T. Efficacy of ketogenic diet: which epilepsies respond?. Revista Epilepsia. Melborne, v. 53, n. 3, p. 55–59, mar. 2012.
VACCAREZZA, M.; AGUSTINHO, A.; ALBERTI, M. J.; ARGUMEDO, L.; ARMENO M.; BLANCO, V.; et al. Consenso nacional de dieta Atkins modificada. Revista Neurologica. Buenos Aires, v. 62, n. 8, p. 371–376, abri. 2016.
VASCONCELOS, C.; ROLA, M.; Dieta Cetogénica - Abordagem Nutricional. Revista Nutrícias. Porto; n.22, p.16-19. Set. 2014.
VAN DER LOUW, E.; VAN DEN HURK, D.; NEAL, E.; LEIENDECKER B.; FITZSIMMON, G.; DORITY, L.; et al. Ketogenic diet guidelines for infants with refractory epilepsy. European journal of paediatric neurology. Official journal of the European Paediatric Neurology Society. Rotterdam, v. 20, n. 6, p. 798-809, nov. 2016.
WINESETT, S. P.; BESSONE, S. K.; KOSSOFF, E. H. The ketogenic diet in pharmacoresistant childhood epilepsy. Expert Review Neurotherapeutics, Saint Pethersburg, v.15, n. 6, p. 621-8, jun 2015.
WHELESS, J. W. History of the ketogenic diet. Revista Epilepsia. Memphis, v.49, n. 8, p. 3–5, nov. 2008.
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Copyright (c) 2024 Gabriela Leite Marques Nóia, Maria Kaliane de Oliveira Pereira, Mayra Vieira Pereira Targino, Débora Gomes de Sousa Araújo, Walnara Arnaud Moura Formiga, Maria Yasmin Paz Teixeira Martins, Nataly Cézar de Lima Fernandes, Sarah Queiroga de Sousa, Maríllia Raquel de Lima, Larruama Priscylla Fernandes de Vasconcelos Lino, Kilmara Janice Vieira de Sá Cândido, Sabrina Bezerra da Silva