title: Refractory epilepsy and the ketogenic diet: pathophysiological aspects and possible implications in dental practice.
abstract: Epilepsy denotes any disorder characterized by recurrent seizures due to abnormal paroxysmal neuronal discharge in the brain. Symptoms range from sensory absences to convulsive movements and loss of consciousness. Antiepileptic drugs are the first line of treatment. However, 20% individuals with epilepsy have drug-resistant seizures despite optimal treatment. For those with refractory epilepsy, the ketogenic diet is an effective alternative therapeutic approach. The ketogenic diet is a high-fat, low-carbohydrate, and adequate-protein diet that mimics the biochemical effects of fasting. There are many disparate mechanistic theories of how this diet protects against seizures. Key insights indicate that it has effects on intermediary metabolism that influence the dynamics of the major inhibitory and excitatory neurotransmitter systems in brain. This paper discusses the implicitly significant and diverse biochemical changes affected by this unique therapeutic approach that may have a bearing on oral health and the delivery of dental care to individuals with refractory epilepsy.
authors: Pedodontics and Preventive Dentistry, Centre for Dental Education and Research All India Institute of Medical Sciences, New Delhi, India.
authors: A
authors: A
authors: Sharma
authors: V P
authors: VP
authors: Mathur
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D017742:Dental Care for Chronically Ill; D055423:Diet, Ketogenic; D004351:Drug Resistance; D004827:Epilepsy / Q000178:diet therapy* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D018377:Neurotransmitter Agents / Q000502:physiology; D009909:Oral Health
chemical_list: D000927:Anticonvulsants; D018377:Neurotransmitter Agents