Impacto nutricional da dieta cetogênica na epilepsia refratária infantil de difícil controle
Arquivos
Data
2004
Autores
Ramos, Ana Maria Figueiredo 
Orientadores
Gabbai, Alberto Alain
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A dieta cetogênica caracteriza-se por ser hiperlipídica,
normoprotéica e hipoglicídica, levando ao estado de cetose. O mecanismo da dieta cetogênica ainda não está claro, porém, têm-se demonstrado uma forma terapêutica adequada nos casos de epilepsia refratária com crises do tipo Tônico-clônico, crises parciais, mioclônicas, e crises de ausência. A dieta produz um estado crônico cetose, com efeito, anticonvulsivante. Objetivos:
Analisar a importância da dieta cetogênica utilizada em crianças e
adolescentes com epilepsia de difícil controle e que não respondem a terapia medicamentosa. Metodologia: A dieta foi iniciada com a hospitalização de crianças em jejum durante 36 a 48 horas, até entrarem em cetose (4+); quatro importantes itens necessários para o cálculo da dieta foram acompanhados:
peso ideal, calorias por Kg de peso, proporção da dieta cetogênica (gordura/proteínas/carboidratos) e ingestão hídrica. Resultados: 12 crianças entre 6 a 17 anos foram submetidas à dieta cetogênica, 4 delas, até o presente momento, apresentaram redução nas crises e melhora em aspectos psicológicos e motores e melhora entre 70 – 100% na qualidade de vida. Uma
das crianças com a Síndrome de Lennox Gestaut após dez dias de dieta chegou ao ambulatório tendo um controle das crises e balbuciando as primeiras palavras. Um dos adolescentes, que usualmente passava a maior parte do dia dormindo por conta da medicação, atualmente apresenta vida regular normal, voltaram à escola e estão pintando. Não houve casos de má nutrição
após a dieta cetogênica, colesterol sérico e triglicérides não sofreram aumento em seus níveis. Conclusão: Em relação ao custo, não foram encontrados obstáculos para introduzir a dieta cetogênica, já que partes não convencionais dos alimentos podem ser utilizadas, tornando as preparações mais acessíveis à família.
Introduction: The Ketogenic Diet consists in a fat high, protein normal and carbohydrate low diet, leading to a ketosis state. The mechanism of the ketogenic diet is still not clear, however it has been showing to be a good form of therapeutic in refractory cases of tonic-clonic seizures, complex partial seizure, myoclonic seizures, and acinetic and absence crisis. The Ketogenic Diet produces a chronic ketosis state, and the ketosis and its anticonvulsive effects were available after the present understanding and conclusion concerning the real play of ketogenic bodies. This diet was called ketogenic diet upon the observation that epileptic patients have presented greater control of their convulsive crisis during the dietotherapic treatment. After fasting, the diet begins by restricting the quantity of carbohydrate and protein, which are adapted to the ideal weight of the child and enriching with high fat food, mainly mono and polyunsaturated.. It seems to be efficient in children and adolescent. In order to obtain a successful treatment, family members’ need all support, follow up and motivation they can get. Objective: The importance of Ketogenic Diet Used to help Children and Adolescents with hard control Epilepsy, who does not respond to pattern pharmacological therapy. Method: The diet begins by hospitalizing the child with a 36 to 48 hours fasting, so that the child gets to ketosis (4+). Four very important items to the precise calculation of the diet evaluated the patients: Ideal weight; Calories for kilogram; Ketogenic proportion (fat/protein/carbohydrate); Liquid ingestion. Results: Twelve children from 6 to 17 years old who were under the Ketogenic Diet were evaluated. Four of them, up to the present moment, had their crises reduced, improvements at the psychosocial and motor aspects and 70-100% the life quality. One of the children with Lennox Gestaut Syndrome has started to feel secure at ambulation and balanced affective emotional control, even stammering the first words. One of the adolescents, who used to spend most part of the day sleeping due to medication, takes a regular life nowadays, he is back to school and he is even painting. There were not cases of malnutrition after Ketogenic Diet beginning as well as increase of the cholesterol levels and triglycerides. Conclusion: Regarding cost effective, we have not found obstacles that could be considered barriers to proceed with the Ketogenic Diet, since we can use the unconventional parts of the food, making the treatment less expensive to the families.
Introduction: The Ketogenic Diet consists in a fat high, protein normal and carbohydrate low diet, leading to a ketosis state. The mechanism of the ketogenic diet is still not clear, however it has been showing to be a good form of therapeutic in refractory cases of tonic-clonic seizures, complex partial seizure, myoclonic seizures, and acinetic and absence crisis. The Ketogenic Diet produces a chronic ketosis state, and the ketosis and its anticonvulsive effects were available after the present understanding and conclusion concerning the real play of ketogenic bodies. This diet was called ketogenic diet upon the observation that epileptic patients have presented greater control of their convulsive crisis during the dietotherapic treatment. After fasting, the diet begins by restricting the quantity of carbohydrate and protein, which are adapted to the ideal weight of the child and enriching with high fat food, mainly mono and polyunsaturated.. It seems to be efficient in children and adolescent. In order to obtain a successful treatment, family members’ need all support, follow up and motivation they can get. Objective: The importance of Ketogenic Diet Used to help Children and Adolescents with hard control Epilepsy, who does not respond to pattern pharmacological therapy. Method: The diet begins by hospitalizing the child with a 36 to 48 hours fasting, so that the child gets to ketosis (4+). Four very important items to the precise calculation of the diet evaluated the patients: Ideal weight; Calories for kilogram; Ketogenic proportion (fat/protein/carbohydrate); Liquid ingestion. Results: Twelve children from 6 to 17 years old who were under the Ketogenic Diet were evaluated. Four of them, up to the present moment, had their crises reduced, improvements at the psychosocial and motor aspects and 70-100% the life quality. One of the children with Lennox Gestaut Syndrome has started to feel secure at ambulation and balanced affective emotional control, even stammering the first words. One of the adolescents, who used to spend most part of the day sleeping due to medication, takes a regular life nowadays, he is back to school and he is even painting. There were not cases of malnutrition after Ketogenic Diet beginning as well as increase of the cholesterol levels and triglycerides. Conclusion: Regarding cost effective, we have not found obstacles that could be considered barriers to proceed with the Ketogenic Diet, since we can use the unconventional parts of the food, making the treatment less expensive to the families.
Descrição
Citação
RAMOS, Ana Maria Figueiredo. Impacto nutricional da dieta cetogênica na epilepsia refratária infantil de difícil controle. 2004. 148 f. Dissertação (Mestrado) - Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2004.