Therapeutic augmentation of ketogenic diet with a sodium-glucose cotransporter 2 inhibitor in a super-refractory status epilepticus patient

Joseph R Blunck; Joseph W Newman; Ronald K Fields; John E Croom

doi:10.1016/j.ebcr.2018.05.002

Therapeutic augmentation of ketogenic diet with a sodium-glucose cotransporter 2 inhibitor in a super-refractory status epilepticus patient

Epilepsy Behav Case Rep. 2018 Jun 20:10:61-64. doi: 10.1016/j.ebcr.2018.05.002. eCollection 2018.

Authors

Joseph R Blunck¹, Joseph W Newman¹, Ronald K Fields¹, John E Croom¹

Affiliation

¹ Saint Luke's Hospital, 4401 Wornall Rd., 64111 Kansas City, MO, United States of America.

Abstract

Background: A ketogenic diet (KD) may have a role in treating patients in super-refractory status epilepticus (SRSE). Sodium-glucose cotransporter 2 (SGLT2) inhibitors have a risk of ketoacidosis that could facilitate induction of KD.

Case summary: A 42-year-old with a history of drug resistant epilepsy developed SRSE requiring several pharmacological interventions during her hospital course including the initiation of KD that failed. SGLT2 inhibitor therapy was initiated in a successful attempt to augment ketone production.

Conclusion: SGLT2 inhibitors may have a therapeutic value in SRSE patients who cannot achieve ketosis with KD alone.

Keywords: Epilepsy; Ketoacidosis; Ketogenic diet; Ketosis; Pentobarbital; Refractory status epilepticus; Seizure; Sodium-glucose cotransporter 2 inhibitor; Status epilepticus; Super-refractory status epilepticus.

Publication types

Case Reports