Dados do Trabalho
QUANTITATIVE ANALYSIS OF ELECTROENCEPHALOGRAMS PERFORMED IN A PATIENT SUBMITTED TO KETOGENIC DIET. ARE THERE CHANGES IN BRAIN ELECTRICAL ACTIVITY IN STATE OF KETOSIS?
The ketogenic diet is a medical treatment indicated for the control of epileptic seizures in patients diagnosed with Drug-Resistant Epilepsy. Several cohort series have reported the effectiveness of the diet. In a bibliographic review in PUBMED on electroencephalographic analysis as proof of the anti-crisis effect of the ketogenic diet, it was observed that, in most studies, visual counts were performed without systematic quantitative analysis using certified mathematical programs.
To prospectively and quantitatively investigate brain electrophysiological transformations of a patient with Drug-Resistant Epilepsy and treated with ketogenic diet, through specific mathematical/computational programs aimed at quantitative analysis of electroencephalograms performed.
A prospective, comparative and quantitative longitudinal analysis (December 10, 2021 to March 31, 2022) was carried out, in which 3 electroencephalograms were performed in a female patient, at 3 years of age, with diagnosis of Drug-Resistant Epilepsy due to Neonatal Ischemic Hypoxic Encephalopathy, with indication of ketogenic diet. They were performed according to homogeneous protocols. The patient had her blood ketosis levels measured daily.
Resultados e Conclusões
Statistical significance was observed in the reduction in the frequency of epileptic seizures as ketosis levels were established, as well as in the reduction in the overall frequency of reported epileptic seizures, reduction in the DELTA band and increase in the THETA and ALPHA bands in the frontal regions associated with increased entropy in the same territory, with no changes to the visual inspection of the electroencephalogams. These findings imply that these physiological changes are related to the reduction of reported epileptic seizures, even though there are no visual changes to electroencephalogam tracings. Thus, the visual evolution of the electroencephalogam MAY NOT BE A PARAMETER FOR DEFINITION OF RESPONSE TO THE KETOGENIC DIET.
Epilepsy, Ketogenic Diet, Electroencephalography, Mathematical Analysis
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Não apresentam conflitos de interesse
Fonte de Fomento (se houver)
Referências (se houver)
CROSS, J. Helen; NEAL, Elizabeth G. The ketogenic diet - Update on recent clinical
trials. Epilepsia, [s. l.], v. 49, n. SUPPL. 8, p. 6–10, 2008.
FISHER, Robert S et al. Epileptic Seizures and Epilepsy: Definitions Proposed by
the International League Against Epilepsy (ILAE) and the International Bureau
for Epilepsy (IBE)Epilepsia. [S. l.: s. n.], 2005.
FISHER, Robert S. et al. ILAE Official Report: A practical clinical definition of epilepsy.
Epilepsia, [s. l.], v. 55, n. 4, p. 475–482, 2014.
HE, Fang et al. Efficacy of the ketogenic diet in Chinese adults versus children with
drug-resistant epilepsy : A pilot study. Epilepsy & Behavior, [s. l.], v. 134, p. 108820,
2022. Disponível em: https://doi.org/10.1016/j.yebeh.2022.108820.
KWAN, Patrick et al. Definition of drug resistant epilepsy : Consensus proposal by the
ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. [s. l.], v. 51, n.
6, p. 1069–1077, 2010.
LI, Baomin et al. Effects of ketogenic diet on the clinical and electroencephalographic
features of children with drug therapy ‑ resistant epilepsy. [s. l.], p. 611–615, 2013.
MARTIN, Kirsty et al. Ketogenic diet and other dietary treatments for epilepsy.
Cochrane Database of Systematic Reviews, [s. l.], v. 2016, n. 2, 2016.
MEIRA, Isabella D'Andrea et al. Ketogenic diet and epilepsy: What we know so far.
Frontiers in Neuroscience, [s. l.], v. 13, n. JAN, p. 1–8, 2019.
PEREIRA, Érica et al. ARTIGO DE REVISÃO Dieta cetogênica: como o uso de uma
dieta pode interferir em mecanismos neuropatológicos Ketogenic diet: how to use a
diet can interfere with mechanisms neuropathological. méd. biol, [s. l.], v. 9, p. 78–82,
SAMPAIO, Leticia Pereira de Brito. ABC da dieta cetogênica para epilepsia
refratária. 1a ediçãoed. Rio de Janeiro: DOC Content, 2018.
SIRVEN, Joseph I. Management of epilepsy comorbidities. CONTINUUM Lifelong
Learning in Neurology, [s. l.], v. 22, p. 191–203, 2016. Disponível em:
omorbidities.15.aspx. Acesso em: 18 jul. 2022.
STROINK, Hans et al. The first unprovoked, untreated seizure in childhood: A hospital
based study of the accuracy of the diagnosis, rate of recurrence, and long term
outcome after recurrence. Dutch study of epilepsy in childhood. Journal of Neurology
Neurosurgery and Psychiatry, [s. l.], v. 64, n. 5, p. 595–600, 1998.
WIRRELL, Elaine et al. Introduction to the epilepsy syndrome papers. Epilepsia, [s.
l.], v. 63, n. 6, p. 1330–1332, 2022.
YUM, Myung-kul et al. Effect of a ketogenic diet on EEG : Analysis of sample entropy.
[s. l.], 2008.
Hospital Universitário Onofre Lopes - Rio Grande do Norte - Brasil, Instituto Santos Dumont - Rio Grande do Norte - Brasil
STELLA MANDU CICCO, NICELLE DE MORAIS CANDEZ, ARIANY CIBELLE COSTA REZENDE , NATHÁLIA DANTAS DE FREITAS RÊGO, HUGO MATOS BANDEIRA