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Nonpharmacologic care for patients with L ennox‐ G astaut syndrome: Ketogenic diets and vagus nerve stimulation
Author(s) -
Kossoff Eric H. W.,
Shields W. Donald
Publication year - 2014
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.12546
Subject(s) - ketogenic diet , vagus nerve stimulation , vagus nerve , stimulation , epilepsy , medicine , anesthesia , lennox–gastaut syndrome , adjunctive treatment , psychiatry
Summary Individuals with L ennox‐ G astaut syndrome ( LGS ) often do not respond to or become resistant to pharmacologic treatments. Ketogenic diets ( KDs ) and vagus nerve stimulation ( VNS ) are nonpharmacologic treatment options for these intractable patients. The classic KD , a high‐fat, low‐carbohydrate diet with 90% of calories derived from fat, has been used in the treatment of seizures for >90 years. About half of patients with LGS respond to the KD with a >50% reduction in seizures and some patients may achieve a >90% reduction. Vagus nerve stimulation therapy involves a surgically implanted generator that delivers intermittent electrical stimuli to the brain via an electrode wrapped around the left vagus nerve. It is utilized as adjunctive therapy for patients with drug‐resistant epilepsy (including patients with LGS ) who are not suitable candidates for resective surgery. Similar to the KD , about half of LGS patients respond to VNS therapy, with a >50% reduction in seizures, and the response may improve over time. Both the KD and VNS are options for patients with LGS .