Moumou, male, 3 years old in August, weight 18kg, in order to interrupt convulsions for 3 years, for the survival of the ketone diet treatme
Moumou, male, 3 years old in August, weight 18kg, in order to interrupt convulsions for 3 years, for the survival of the ketone diet treatment admission. Tic children 3 years ago showed fever, loss of consciousness, pale purple, eyes, head and limbs jitter, lasting about 40 minutes after the seizure remission, no sleep, koutubaimo, screaming, no rash, cough, vomiting, diarrhea, fluid, frequent daily, every time is basically the same in Zhengzhou, many times in our hospital and many other hospitals for treatment, the EEG showed single high amplitude, high amplitude sharp and sharp slow wave complex, on the forehead, central, diagnosed as epilepsy, give you the formal treatment of sodium valproate oral liquid, phenobarbital, lamotrigine, levetiracetam "the drug for 3 years, is now taking the children with" Sodium Valproate Syrup, left Ne Laci Staw, lamotrigine three drug treatment, there are still attack, once a week, lasted for a long time, must be injected with benzene Pakistan Vinylbital or use of diazepam can alleviate. Physical examination: growth retardation, chicken, heart lungs abdomen abnormal limbs muscle strength of grade 4, normal muscular tension, only walking instability, easy to fall, hands less flexible, physiological reflex, bilateral Babinski sign. Primary diagnosis: intractable epilepsy. Diagnosis: 1 patients, male, 3 years old in August, "3 years of intermittent convulsions, EEG showed: single high amplitude and high amplitude sharp and sharp slow wave complex, on the forehead, central, diagnosed as epilepsy, 2, physical examination: the development of backward strength 4, go alone instability of hands is less flexible. It has not been completely controlled by a variety of drugs, so it is difficult to diagnose epilepsy. After admission, 1 children with convulsions, diazepam enema after remission. The relevant examination and allow children in body condition, start the ketogenic diet therapy, after 21 hours of fasting, with ketone reach 4.4mmol/L, glucose was 3.0mmol/L, reached the standard, given the ketogenic diet (fat, protein and carbohydrate ratio 4:1), calculation of heat per kg of body weight 60-80 kcal, with weight according to the daily 60 thousand card points exceed the standard, calculation, 18*60=1080 kcal, the first day of giving a total heat 1/3 (360 thousand cards), no adverse reactions, blood ketone is stable, above 4mmol/L, normal blood glucose, no convulsions; for second days total calorie 2/3 (720 thousand calories), no adverse reactions were compared with blood ketone stable, at around 4.5mmol/L, normal blood glucose, no convulsions; third days to give a full calorie (1 million 80 thousand calories), no adverse reactions, blood ketone is stable, maintained at more than 3.0mmol/L, blood Sugar is normal, no convulsions, blood ketone decreased, fourth days return second days, blood ketone and increased to 4.0mmol/L, normal blood glucose, with some lethargy, no other discomfort, no convulsions; fifth days to give full heat, blood ketone is maintained at 4.0mmol/L, to inform the families of children with increased activity, to burn calories help, every day after giving the full amount of ketogenic, blood glucose, ketone, stable, free to attack in the hospital for 1 weeks to review the relevant examination, no abnormal discharge, after discharge of the ketogenic diet, diet period in strict accordance with the formulated diet plan. 2 weeks after discharge were again convulsion, with longer duration, given phenobarbital after remission, I rechecked blood ketone and blood glucose again, blood ketone 3.0mmol/L, glucose 5.0mmol/L, general > 4.0mmo/L, blood ketone; seizure control effect is better, consider the children body level is not high enough so to lead the attack again more calories can also cause blood ketone do not, and children activity is not enough can also lead to excessive heat, adjust them with 55 thousand calories per kilogram of body weight, total calories 55*18=990 kcal, adjust the heat with ketone reaches about 5.0mmol/L, the basic control of seizures, there is a slight attack for a few seconds can be relieved, no obvious adverse reaction. From this case, the ketogenic diet in the treatment of refractory epilepsy disease is safe and effective, can adjust the heat according to the situation of children, the ketone body reaches a certain height to increase the curative effect.