Frontiers in Neurology (Jul 2023)
Ketogenic dietary therapies in epilepsy: recommendations of the Italian League against Epilepsy Dietary Therapy Study Group
- Valentina De Giorgis,
- Valentina De Giorgis,
- Anna Tagliabue,
- Francesca Bisulli,
- Francesca Bisulli,
- Ilaria Brambilla,
- Alessandra Camerini,
- Raffaella Cusmai,
- Francesca Darra,
- Alice Dianin,
- Elia Domenica,
- Monica Anna Maria Lodi,
- Sara Matricardi,
- Tullio Messana,
- Francesca Operto,
- Francesca Ragona,
- Emilio Russo,
- Costanza Varesio,
- Costanza Varesio,
- Lilia Volpi,
- Martina Paola Zanaboni,
- Ludovica Pasca,
- Ludovica Pasca,
- Pierangelo Veggiotti,
- Pierangelo Veggiotti
Affiliations
- Valentina De Giorgis
- Department of Brain and Behaviour Neuroscience, University of Pavia, Pavia, Italy
- Valentina De Giorgis
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
- Anna Tagliabue
- Department of Public Health, Human Nutrition and Eating Disorder Research Center and Ketogenic Metabolic Therapy Laboratory—Experimental and Forensic Medicine University of Pavia, Pavia, Italy
- Francesca Bisulli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the European Reference Network for Rare and Complex Epilepsies (EpiCARE), Bologna, Italy
- Francesca Bisulli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Ilaria Brambilla
- Endocrinologia, Diabetologia e Ginecologia Pediatrica, Fondazione IRCCS Policlinico San Matteo di Pavia, Università degli Studi di Pavia, Pavia, Italy
- Alessandra Camerini
- Italian GLUT1-DS Association, Milan, Italy
- Raffaella Cusmai
- Child Neurology Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Research Hospital, IRCCS, Rome, Italy
- Francesca Darra
- Child Neuropsychiatry Unit, Department of Engineering for Innovation Medicine, University of Verona, Full Member of European Reference Network EpiCARE, Verona, Italy
- Alice Dianin
- 0Inherited Metabolic Diseases Unit and Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
- Elia Domenica
- 1Artificial Nutrition Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
- Monica Anna Maria Lodi
- 2Department of Child Neuropsychiatry, Epilepsy Center, Fatebenefratelli Hospital, Milan, Italy
- Sara Matricardi
- 3Department of Pediatrics, University of Chieti, Chieti, Italy
- Tullio Messana
- 4Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell'etá pediatrica, Member of the ERN Epicare, Bologna, Italy
- Francesca Operto
- 5Department of Science of Health, School of Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
- Francesca Ragona
- 6Department of Pediatric Neurology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
- Emilio Russo
- 7Science of Health Department, University of Catanzaro, Catanzaro, Italy
- Costanza Varesio
- Department of Brain and Behaviour Neuroscience, University of Pavia, Pavia, Italy
- Costanza Varesio
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
- Lilia Volpi
- 8UOC Neurologia, IRCCS Istituto delle Scienze Neurologiche, Azienda USL di Bologna, Ospedale Bellaria Bologna, Bologna, Italy
- Martina Paola Zanaboni
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
- Ludovica Pasca
- Department of Brain and Behaviour Neuroscience, University of Pavia, Pavia, Italy
- Ludovica Pasca
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
- Pierangelo Veggiotti
- 9Vittore Buzzi Children's Hospital, Pediatric Neurology Unit, Milan, Italy
- Pierangelo Veggiotti
- 0Department of Biomedical and Clinical Sciences, L. Sacco, University of Milan, Milan, Italy
- DOI
- https://doi.org/10.3389/fneur.2023.1215618
- Journal volume & issue
-
Vol. 14
Abstract
A stepwise increase in the utilization of ketogenic dietary therapies for drug-resistant epilepsy has been observed in Italy in the last decade, although it is still considered often underused in many centers when compared to other countries. The Dietary Therapy Study Group of the Italian League against Epilepsy proposes practical recommendations to improve shared knowledge and facilitate the application of ketogenic dietary therapies, optimizing its efficacy and tolerability. The experts involved (11 child neuropsychiatrists, two adult neurologists, one psychologist, one pharmacologist, one pediatric endocrinologist, one representative of patients' associations, and three dietitians and clinical nutritionists) responded to a survey on current clinical practice issues and were asked to discuss controversial topics related to supplementation, long-term maintenance, transition, and a multidisciplinary approach to ketogenic dietary therapies. Practical indications for patient selection, diet initiation, management, side effects prevention, and follow-up are provided.
Keywords
- Ketogenic dietary therapies
- consensus
- recommendations
- drug resistant epilepsy
- multidisciplinary approach
- target treatment
