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J Child Neurol. 2013 Aug;28(8):1049-51. doi: 10.1177/0883073813487601. Epub 2013 May 1.

Use of dietary therapy for status epilepticus.

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John M. Freeman Pediatric Epilepsy Center, Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.


One of the newest and yet fastest growing indications for dietary therapy is the emergency treatment of refractory status epilepticus. Ten retrospective publications since 2008 have reported benefits in 32 children and adults, of whom 25 (78%) became seizure-free. Most of the patients who responded did so within 7 to 10 days of the initiation of nasogastrically administered ketogenic formulas. Encephalitis and febrile-illness related epilepsy syndrome causing status epilepticus highly refractory to antiepileptic drugs may be particularly amenable to dietary treatment. Prospective, multicenter studies are under way to help clarify who best will respond, how quickly, and the optimal diet duration after success.


FIRES; emergency; epilepticus; ketogenic; refractory; status

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