Efektivitas Diet Ketogenik dalam Penurunan Frekuensi Kejang pada Anak Dengan Epilepsi Resisten Obat
DOI:
https://doi.org/10.55606/termometer.v1i1.974Keywords:
Anak, diet ketogenik, epilepsi resisten obat, modified Atkins diet, frekuensi kejangAbstract
Lebih dari 30% pasien epilepsi tidak mencapai kontrol kejang dengan obat antiepilepsi (OAE) dan disebut sebagai epilepsi resisten obat. OAE juga menyebabkan berbagai efek samping sehingga dipertimbangkan jenis terapi lain. Diet ketogenik, yakni diet tinggi lemak dan rendah karbohidrat, adalah salah satu terapi diet yang sudah dikenal sejak dahulu untuk terapi epilepsi. Saat ini juga sudah dikenal berbagai variasi diet ketogenik klasik, seperti modified Atkins diet (MAD). Pengumpulan literatur dilakukan melalui database PubMed, ScienceDirect, dan Cochrane menggunakan kata kunci berikut: “drug resistant epilepsy”, “refractory epilepsy”, “ketogenic diet”, dan “seizure frequency”. Artikel yang digunakan yaitu yang dipublikasi sejak Januari 2020 s.d. Desember 2022. Setelah melalui skrining dan seleksi artikel, didapatkan 11 artikel (4 tinjauan sistematis dan meta-analisis, 4 kohort retrospektif, 2 uji klinik terkontrol acak, dan 1 kohort prospektif). Setelah terapi diet ketogenik, didapatkan proporsi anak dengan reduksi frekuensi kejang (RFK) ≥50% bervariasi antara 45—80% dan proporsi anak bebas kejang antara 7—35%. Satu meta-analisis menemukan bahwa dibandingkan DK klasik (4:1), MAD (1:1 s.d. 2:1) sedikit kurang efektif dalam menghasilkan RFK ≥50% (RR=0,63 [0,79-0,83]), tetapi sama efektif dalam menghasilkan RFK ≥90% (RR=0,73 [0,49-1,10]) dan bebas kejang (RR=0,83 [0,49-1,41]). Diet ketogenik, apapun variasinya, efektif dalam menurunkan frekuensi kejang pada anak dengan epilepsi resisten obat.
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