Burak TATLI, Barış EKİCİ, Ayşe Nurcan CEBECİ

Çocukluk çağı epilepsilerinde diyet tedavisi

Yüksek yağ ve düşük karbonhidrat içeren ketojenik diyet 1920’lerin başında epilepsi tedavisinde kullanılmaya başlanmıştır. Fenitoin gibi yeni ilaçların keşfiyle 90’lara kadar unutulmuş eski bir tedavi olarak kalmıştır.Dirençli epilepside ketojenik diyet ile hastaların yarısının nöbet sayılarında belirgin azalma ve yaklaşık %15’inde ise tam nöbet kontrolü bildirilmiştir. Önceleri son tedavi tercihleri arasında yer alan diyet, artan bilgi birikimi ve daha kolay uygulanabilir değiştirilmiş formların da etkinliğinin görülmesiyle miyoklonik, astatik epilepsi, Dravet sendromu ve süt çocuğu spazmı gibi epileptik ansafalopatilerde ilk tedavi seçenekleri arasına yerleşmiştir.

Dietary therapies for childhood epilepsy

Ketogenic diet composed of high fat and low carbonhydrate was introduced as a therapeutic alternative for epilepsy in early 20’s. As new antiepileptic agents such as phenytoin were discovered, popularity of the diet was waned until 90’s. Studies on efficacy of diet in refractory epilepsy reported that approximately half of the children had a significant reduction, 15% of whom were seizure free. With growing body of evidence and introduction of diet modifications, ketogenic diet was promoted as a first line treatment for epileptic encephalopathies such as myoclonic-astatic epilepsy , Dravet syndrome and infantile spasm.

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