This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Rosenthal, E. Articles by Kyllonen, K. Search for Related Content PubMed PubMed Citation Articles by Rosenthal, E. Articles by Kyllonen, K. Social Bookmarking                         What's this?

Use of Parenteral Medium-Chain Triglyceride Emulsion for Maintaining Seizure Control in a 5-Year-Old Girl with Intractable Diarrhea

Departments of Nutrition Services and Pharmacy Services, Rainbow Babies and Children's Hospital, University Hospitals of Cleveland, Cleveland, Ohio, Division of Pediatric Neurology, Emory University School of Medicine, Atlanta, Georgia

Barbara Weissman, M.D.

Departments of Nutrition Services and Pharmacy Services, Rainbow Babies and Children's Hospital, University Hospitals of Cleveland, Cleveland, Ohio, Division of Pediatric Neurology, Emory University School of Medicine, Atlanta, Georgia

Kay Kyllonen, PHARM.D.

Departments of Nutrition Services and Pharmacy Services, Rainbow Babies and Children's Hospital, University Hospitals of Cleveland, Cleveland, Ohio, Division of Pediatric Neurology, Emory University School of Medicine, Atlanta, Georgia

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. (Journal of Parenteral and Enteral Nutrition 14:543-545, 1990)

Journal of Parenteral and Enteral Nutrition, Vol. 14, No. 5, 543-545 (1990)
DOI: 10.1177/0148607190014005543


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				S. J. Phelps, C. A. Hovinga, D. F. Rose, C. Vaughn, and K. Olsen-Creasy The Ketogenic Diet in Pediatric Epilepsy Nutr Clin Pract, December 1, 1998; 13(6): 267 - 282. [Abstract] [PDF]