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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Epilepsy
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1517850

Ketogenic diet treatment for super-refractory status epilepticus in the intensive care unit: feasibility, safety and effectiveness

Provisionally accepted
Yishu Ren Yishu Ren 1Mengyao Zhang Mengyao Zhang 1Xinxiao Fu Xinxiao Fu 2Yan Zhang Yan Zhang 1Fang Liu Fang Liu 1Chenlin Wu Chenlin Wu 3Haiyan Shi Haiyan Shi 3Fei Tian Fei Tian 1Gang Liu Gang Liu 1Yicong Lin Yicong Lin 1Yingying Su Yingying Su 1Weibi Chen Weibi Chen 1*
  • 1 Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
  • 2 Department of Neurology, Qingyuan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Qingyuan, China
  • 3 Department of Neurology, Beijing Fengtai Youanmen Hospital, Beijing, China

The final, formatted version of the article will be published soon.

    Background &Aims: To investigate the feasibility, safety and effectiveness of the ketogenic diet (KD) for super-refractory status epilepticus (SRSE) in the intensive care unit (ICU).We conducted a prospective investigation on patients with SRSE treated with the KD. The primary outcome measures were ketosis development as a biomarker of feasibility and resolution of SRSE as effectiveness. KD-related side effects were also investigated.Results: Twelve patients (9 females and 3 males) with SRSE, with a median age of 34 years [range 16-69, interquartile range (IQR) 18-52], were treated with a KD. The median duration of SRSE prior to KD treatment was 21 days [range 4-46]. SRSE resolved in 75% (9/12) of patients at a median of 3 days (range 1-18) after KD initiation. Among the nine KD responders, all were successfully weaned off anesthetic agents at a median of 16 days (range 4-32) after KD initiation, and all were also successfully weaned off ventilator. Side effects varied, and included gastrointestinal intolerances, malnutrition and metabolic abnormalities, electrolyte disturbance, and acute weight loss, although most of them could be corrected. No patient died due to KD, and neurofunctions continued to improve under KD therapy.The KD may be feasible and effective for the treatment of SRSE in the ICU. Moreover, it is relatively safe. However, there are numerous adverse events that can be corrected under close monitoring.

    Keywords: Ketogenic Diet, Status Epilepticus, refractory status epilepticus, Encephalitis, Intensive Care Unit

    Received: 27 Oct 2024; Accepted: 24 Dec 2024.

    Copyright: © 2024 Ren, Zhang, Fu, Zhang, Liu, Wu, Shi, Tian, Liu, Lin, Su and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Weibi Chen, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.