RT Journal Article
SR Electronic
T1 International Recommendations for the Management of Adults Treated With Ketogenic Diet Therapies
JF Neurology: Clinical Practice
FD Lippincott Williams & Wilkins
SP 385
OP 397
DO 10.1212/CPJ.0000000000001007
VO 11
IS 5
A1 Mackenzie C. Cervenka
A1 Susan Wood
A1 Manny Bagary
A1 Antoaneta Balabanov
A1 Eduard Bercovici
A1 Mesha-Gay Brown
A1 Orrin Devinsky
A1 Cherubino Di Lorenzo
A1 Colin P. Doherty
A1 Elizabeth Felton
A1 Laura A. Healy
A1 Pavel Klein
A1 Magnhild Kverneland
A1 Danielle Lambrechts
A1 Jennifer Langer
A1 Janak Nathan
A1 Jude Munn
A1 Patty Nguyen
A1 Matthew Phillips
A1 Kelly Roehl
A1 Adrianna Tanner
A1 Clare Williams
A1 Beth Zupec-Kania
YR 2021
UL http://cp.neurology.org/content/11/5/385.abstract
AB Objective To evaluate current clinical practices and evidence-based literature to establish preliminary recommendations for the management of adults using ketogenic diet therapies (KDTs).Methods A 12-topic survey was distributed to international experts on KDTs in adults consisting of neurologists and dietitians at medical institutions providing KDTs to adults with epilepsy and other neurologic disorders. Panel survey responses were tabulated by the authors to determine the common and disparate practices between institutions and to compare these practices in adults with KDT recommendations in children and the medical literature. Recommendations are based on a combination of clinical evidence and expert opinion regarding management of KDTs.Results Surveys were obtained from 20 medical institutions with >2,000 adult patients treated with KDTs for epilepsy or other neurologic disorders. Common side effects reported are similar to those observed in children, and recommendations for management are comparable with important distinctions, which are emphasized. Institutions differ with regard to recommended biochemical assessment, screening, monitoring, and concern for long-term side effects, and further investigation is warranted to determine the optimal clinical management. Differences also exist between screening and monitoring practices among adult and pediatric providers.Conclusions KDTs may be safe and effective in treating adults with drug-resistant epilepsy, and there is emerging evidence supporting the use in other adult neurologic disorders and general medical conditions as well. Therefore, expert recommendations to guide optimal care are critical as well as further evidence-based investigation.