Define the Management of Epileptic Patients?
The primary treatment of epilepsy is anticonvulsant drugs. The focus of nutritional management is a diet, which is appropriate for growth during childhood and maintenance in adults. Nutrient drug interactions also must be considered and remedial steps must be taken. Whereas anticonvulsant drugs may cause side effects of nutritional significance, folic acid supplements can interfere with the action of one of the drugs- Phenytoin. Food intake can delay the absorption of phenobarbital. Low serum albumin due to a state of malnutrition can result in a higher drug concentration in the blood and thus toxicity. In mild/moderate epilepsy, 'ketogenic diets' are sometimes recommended. A ketogenic diet is a high fat diet, with a ratio of 4:1 or 3:1 of fat b carbohydrate and protein calories. Usually about 75% of the recommended energy intake for weight and height is given. Protein given is about lg/ kg for growth. This leaves a minimal amount of carbohydrate to make up the calories. This diet may be used for upto three years and has been reported effective in young children. A ketogenic diet is designed to produce ketone bodies as a result of incomplete oxidation of fat although the exact mechanism is not known, the ketone body produced by incomplete oxidation of fat (acetone, acetoacetic acid and β hydroxybutric acid) are thought to have an anticonvulsant action and hence are beneficial.