Nonpharmacologic care for patients with Lennox-Gastaut syndrome: Ketogenic diets and vagus nerve stimulation

Eric H.W. Kossoff, W. Donald Shields

Research output: Contribution to journalArticlepeer-review

Abstract

Individuals with Lennox-Gastaut 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.

Original languageEnglish (US)
Pages (from-to)29-33
Number of pages5
JournalEpilepsia
Volume55
Issue numbers4
DOIs
StatePublished - 2014

Keywords

  • Adequate-protein
  • Adjunctive therapy
  • Central nervous system
  • Electric stimuli
  • High-fat

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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