Caso clínico : manejo nutricional de paciente con epilepsia refractaria bajo sedación inducida por status epiléptico.

Abstract

Epilepsy is characterized by the presence of excessive neuronal activity, and status epilepticus (SE), a neurological emergency, is established when 2 or more seizures occur with failure to regain consciousness. The ketogenic diet (KD) has been widely used since the last century for the management of epilepsy, as it has been shown to prevent the development of SE and favors the early suspension of sedatives in patients with epilepsy. In this study, the case of a 21-year-old patient with a history of refractory epilepsy and infantile cerebral palsy who was admitted with a diagnosis of SE was analyzed. An inhospital nutritional plan (enteral/oral ketogenic formulation KetoCal® in a 2.5:1 ratio) and a transition plan at home (ketogenic diet of 1400 kcal with a macronutrient distribution of: CHO 5% = 30 PROT 25% = 60 FATS 70% = 115) were developed. This decision was made based on the evidence supporting the indication of KD as a practical, effective and safe management alternative in children and adults with neurological conditions related to epilepsy. Finally, its concluded that the designed nutritional plan (high in fat, medium in protein, and low in carbohydrates and phosphorus) will decrease the frequency of seizures, improve the quality of life and prevent future neurological emergencies in this patient.