PMID: 2122029Sep 1, 1990Paper

Use of parenteral medium-chain triglyceride emulsion for maintaining seizure control in a 5-year-old girl with intractable diarrhea

JPEN. Journal of Parenteral and Enteral Nutrition
E RosenthalK Kyllonen

Abstract

Medium-chain triglycerides (MCT) are an important component of an enteral ketogenic diet for seizure control. Previously, it was difficult to maintain ketosis when parenteral (iv) nutrition therapy was necessary. The use of iv MCT in a 5-year-old girl with Lennox-Gastaut syndrome who had diarrhea and dehydration is reported. Conventional 20% iv fat emulsion (long-chain triglycerides, LCT) and dextrose free hyperalimentation (HAL) in a 4:1 ketogenic ratio did not maintain adequate ketosis during bowel rest. Compassionate use of iv MCT (Clintec Nutrition) infused as a 70:30 MCT/LCT ratio plus HAL maintained moderate ketosis. Seizures were well controlled during the iv MCT regimen, which allowed normal daily functioning. Complications included abnormal liver function tests and severe iron deficiency anemia of unknown etiology. Serum triglyceride and cholesterol levels increased to 1717 mg/dl and 614 mg/dl, respectively, but decreased with a reduction of lipid infusion and use of an antihyperlipemic drug. Nutritional status was maintained. In this case, iv MCT proved to be a relatively safe and effective short-term method of continuing parenteral nutrition while maintaining ketosis for seizure control.

References

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Citations

Apr 1, 1996·Nutrition·H UlrichV Kvetan
Dec 24, 2011·Brain & Development·Da Eun JungHeung Dong Kim
Sep 7, 2016·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·F ChiusoloS Picardo
Apr 9, 1998·The Annals of Pharmacotherapy·K B TallianC Y Tsao
Mar 29, 2018·Epilepsia Open·Anastasia DresslerMartha Feucht
Jun 22, 2019·Developmental Medicine and Child Neurology·Eric H Kossoff
Jul 18, 2019·Developmental Medicine and Child Neurology·Elles van der LouwUNKNOWN Review Group

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