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The Nutrition and Health series of books has an overriding mission to provide health professionals with texts that are considered essential because each includes: (1) a synthe sis of the state of the science, (2) timely, in -depth reviews by the leading researchers in their respective fields, (3) extensive, up-to-date, fully annotated reference lists, (4) a detailed index, (5) relevant tables and figures, (6) identification of paradigm shifts and the consequences, (7) suggestions of areas for future research, and (8) balanced, data driven answers to patient /health professionals questions that are based upon the totality of evidence rather than the findings of any single study. The series volumes are not the outcome of a symposium. Rather, each editor has the potential to examine a chosen area with a broad perspective, both in subject matter as well as in the choice of chapter authors. The international perspective, especially with regard to public health initiatives, is emphasized where appropriate. The editors, whose trainings are both research- and practice-oriented, have the opportunity to develop a primary objective for their book; define the scope and focus, and then invite the leading authorities from around the world to be part oftheir initiative. The authors are encouraged to provide an overview of the field, discuss their own research, and relate the research findings to potential human health consequences.
Foreword by Philip A. Schwartzkroin, PhD
"This book is a comprehensive summary of the use of the ketogenic diet for treatment of medically intractable epilepsy. This book should be read by all those caring for patients with medically intractable epilepsy, and should be on the shelves of all those involved in supervising the ketogenic diet."-The Lancet
Texte du rabat
Recent advances in our understanding of the ketogenic diet (KD)-a high-fat, low-carbohydrate, adequate-protein diet used for the treatment of medically intractable epilepsy-have produced a resurgence of interest in, and application of, this valuable treatment for the epileptic patient. In Epilepsy and the Ketogenic Diet, internationally recognized researchers and clinicians from around the world synthesize the current state of the science and clinical practice of the KD. On the basic science side, the authors review what is known about the basic biochemical mechanisms of action of the KD at the molecular level, spelling out in detail its complex interactions with nutrient components, neurodevelopment, brain biochemistry, and physiology. They also examine the effects of the KD on the metabolism of fats, amino acids, and carbohydrates in the central nervous system at both the macro and cellular levels. On the clinical side, physicians, dietitians, and nurses provide a full range of information concerning the treatment of seizures with KD, including a detailed assessment of the indications for, and the contraindications and/or complications that arise from its use, detailed equations that permit the caregiver to calculate the actual amounts of different types of foods that can be included in daily diet plans, and documented information on the carbohydrate and calorie content of hundreds of commonly used drugs. Numerous relevant tables, graphs, and figures, as well as up-to-date references, consistent use of terms across chapters, and a highly annotated index ensure easy access to needed information.
Illuminating and highly practical, Epilepsy and the Ketogenic Diet constitutes a unique benchmark synthesis of up-to-date clinical and scientific information that explains the mechanisms behind the KD and how its maximum therapeutic benefits may be realized in the epileptic patient with minimal adverse effects.
Contenu
I. Background.- 1 An Introduction to Seizures and Epilepsy: Cellular Mechanisms Underlying Classification and Treatment.- 2 History and Origin of the Ketogenic Diet.- II. Clinical Aspects.- 3 The Ketogenic Diet: The Physician's Perspective.- 4 Clinical Use of the Ketogenic Diet: The Dietitian's Role.- 5 How to Maintain and Support a Ketogenic Diet Program: A Nursing Perspective.- 6 Efficacy of the Ketogenic Diet.- 7 The Ketogenic Diet in Adults.- 8 Indications and Contraindications of the Ketogenic Diet.- 9 Complications of the Ketogenic Diet.- 10 Measuring and Interpreting Ketosis and Fatty Acid Profiles in Patients on a High-Fat Ketogenic Diet.- 11 Insights From Neuroimaging Studies Into Ketosis and the Ketogenic Diet.- 12 Potential Applications of the Ketogenic Diet in Disorders Other Than Epilepsy.- 13 Dietary Treatments for Epilepsy Other Than the Ketogenic Diet.- III. Basic Science Perspectives.- 14 Effects of the Ketogenic Diet on Cerebral Energy Metabolism.- 15 The Ketogenic Diet: Interactions With Brain Amino Acid Handling.- 16 Molecular Regulation of Ketogenesis.- 17 The Effects of Ketone Bodies on Neuronal Excitability.- 18 Effects of the Ketogenic Diet on Acute Seizure Models.- 19 Caloric Restriction and Epilepsy: Historical Perspectives, Relationship to the Ketogenic Diet, and Analysis in Epileptic EL Mice.- 20 The Role of Norepinephrine in the Anticonvulsant Mechanism of Action of the Ketogenic Diet.- 21 Galanin and Neuropeptide Y: Orexigenic Neuropeptides Link Food Intake, Energy Homeostasis, and Seizure Susceptibility.- 22 The Neuroprotective and Antiepileptogenic Effects of the Ketogenic Diet.- Afterword: A Parent's Perspective on Childhood Epilepsy: The Things I Wish They Had Told Us.- Epilogue.- Appendix A: The Carbohydrate and Caloric Contentof Drugs.- Appendix B: Ketogenic Diet Resources.