KETOGENIC DIETARY TREATMENT OF REFRACTORY EPILEPSY IN CHILDREN: NARRATIVE REVIEW

• DOI: https://doi.org/10.22533/at.ed.159492423012

• Palavras-chave: Refractory Epilepsy. Convulsive Crisis. Alternative Therapy. Diet therapy. Pediatric Patients.

• Keywords: Refractory Epilepsy. Convulsive Crisis. Alternative Therapy. Diet therapy. Pediatric Patients.

• Abstract:

   Epilepsy is a neurological condition resulting from a genetic abnormality or acquired brain damage, characterized by regular and disparate convulsive episodes. Refractory epilepsy, a drug-resistant category, is very common in children and lacks alternative treatments. Therefore, the ketogenic diet - a diet rich in lipids, moderate in proteins and low in carbohydrates - appears as a nutritious and less invasive alternative for pediatric patients with this condition. The objective of this article was to evaluate and discuss the functionality of ketogenic dietary treatment in children with refractory epilepsy, as well as its mechanism of action.
   To this end, a narrative review of studies was carried out in the PubMed/Medline and SciELO public and open access databases, using the indexing terms Ketogenic Diet, Refractory Epilepsia and Children, associated with the Boolean connectors AND, OR and NOT, among the years from 2002 to 2020, restricted to Portuguese and English languages. Abstracts of presentations and meetings, editorials, review articles and studies without sufficient data and other articles that did not meet the inclusion criteria were excluded: articles that included in their primary resolution the effectiveness of ketogenic dietary treatment in children, from 1 year to 13 years, with refractory epilepsy. When carrying out the advanced search, 675 articles were identified in PUBMED/Medline and 13 in SciELO. Then, 11 articles were selected according to the established inclusion and exclusion criteria. Analyzing the selected studies, 8 positive results and 7 adverse effects were found in pediatric patients undergoing ketogenic dietary treatment. It was concluded, from this research, that the ketogenic diet is a therapy used in the treatment of children with refractory epilepsy. Its function is to modulate neurotransmitters through the production of ketone bodies, controlling epileptic seizures and proving beneficial to children who do not respond adequately to conventional medications, despite the existence of reversible adverse effects.