Lybrate Logo
Get the App
For Doctors
Login/Sign-up
Last Updated: Mar 11, 2024
BookMark
Report

Drug-Resistant Epilepsy

Profile Image
Dr. Neeta NaikPediatric Neurologist • 39 Years Exp.MBBS, MD - Pediatrics, DNB (Pediatrics)
lybrate_youtube

Good morning everybody.

Mai Dr. Neeta Naik bol rahi hoon aur mai pediatric neurologist or developmental pediatrician hoon. Aaj main aapse baat karne wali hoon drug resistant epilepsy ke treatment ke bare mein. So, drug-resistant epilepsy kya hoti hai iske bare mein maine mere pehle video mein baat kar chuki hoon. Main aapko aaj bataungi iski treatment kis tareeke se kii jati hai aur jo jankari aapke liye relevant hai uske bare mein mai baat karungi. Drug resistant epilepsy means epilepsy jiski dava se treatment sahi tarike se ya completely nahi hoti ya jaha bacho ke seizures drugs ya medications se control nahi hote hai vaha hum alag tareeke ke treatment use karte hai usme se 1 jo pehla tareeka jyadatar use kiya jata hai usko dietary treatment bolte hain, Dietary treatment of epilepsy. Dusra hai use bolte hai vagal nerve stimulation aur teesra hai epilepsy surgery.

So abi dietary treatment kya hai? So, dietary treatment ye hai ki isme hum bache ka khana badalte hai. Bacha normally jo khana khata hai ya hamara jo Indian diet hai vo bahut carbohydrate intensive hota hai aur usme protein aur fats ki matra kafi kam hoti hai. Drug resistant epilepsy mein 2 ya 3 tareeke ke alag diets istemal kiye jate hai. Usme jo commonly ya oldest tareeka hai use ketogenic diet assay kehte hai. Shayad apne ketogenic diet ye word suna hoga kyunki ye jo dietary treatment hai ye aajkal ki bahut sari utilisation weight loss ke liye bhi ki jaati hai. To isme bache ka jo khana hai jo carbohydrate intense hai jaise ki rice hua, chapati, vegetables, fruits ya jo bhi hum Indian khate hai upma, idli, dosa isko switch karke hum high hume carbohydrate ekdum kam karna hai isme so carbohydrate content is below 5%, 80% approximately fat content hota hai aur 15% approximately protein hota hai. Toh isme isko 4:1, 3:1 ya 2:1 fat to protein + carbohydrate ratio me kiya jata hai. Ye diet is tareeka ka nahi hai ke jo hum ghar mein kar sakte hai ise doctor ki aur dietecian ki supervision ki, pre test ki aur follow-up ki ye charo cheez ki zarurat hai. To jab ketogenic diet ye kyu karte hai kyunki ketogenic diet mein jab fat istemal kiya jata hai energy production ke liye to ketones jo shareer mein paida hote hai vo blood brain barrier cross karke brain pe effect uska hota hai aur uska effect antiepileptic drug ke tarike se hi hota hai jismein brain ki electrical activity kam hojati hai aur 100 me se 30-40% patients mein isme 40-90% seizures control karne ki shamta hai. But the difficulty is ki ketogenic diet kabhi-kabhi bahut jyada mushkil ho sakta hai.

Kabhi kabhi ketogenic diet karna bade bacchon ke liye aasan nahin hai kyunki usme bahut jyada fat khana padta hai jaise ghee, butter, cheeze ye main oil ye cheeze bahut jyada content badh jata hai aur baki content bahut kam ho jata hai isilye iska ek 2nd type of diet hai jisko modified Atkins diet kehte hain. To modified Atkins diet mein protein or fat hum unlimited kha sakte hain aur sirf carbohydrate kaam karna padta hai. Yeh thoda aasan hai, isme measurements kam hai, isme unlimited protein hai so non vegetarian families ke liye bahut jyada aasan ho sakta hai, isme Soya products vegetarian family ke liye use hota hai aur isme bhi the principal is same but this diet is easier to do. Agar dietary treatment karna hai to again I would like to repeat ke supervision ke under hi karna hai aur isme kafi bacchon mein bahut jyada tarike se isme refractive drug-resistant epilepsy mein faida ho sakta hai. Dusri treatment hai use kehte hain VNS ya Vagal nerve stimulation.

Yaha ek equipment hota hai jaise ke aap heart mein pacemaker dalte hai usi tareeke se ek pacemaker jaisa equipment hota hai aur ye equipment chest mein skin ke under surgically dala jata hai. Ye equipment se hamare yaha nas hoti hai jise vagal nerve kehte hai, vagal nerve mein stimulation diya jata hai electrical stimulation aur vagal nerve ye impulses brain ko carry karti hai aur brain ko stimulate karke brain ke jo abnormal electrical activity pe affect karke vo bhi kam hosakta hai. Though ye surgical procedure hai, bahut choti surgery isme hoti hai aur iska bhi bahut jyada hadd tak faida refractory epilepsy mein ho sakta hai. Teesri jo treatment hai use epilepsy surgery kehte hai. Usme 2 type ki surgery hoti hai: lesional ya non-lesional surgery. Agar MRI mein bacchon ke koi ghanth ya koi agar lesion dikhayi deta hai to use nikalna use lesional surgery kehte hai aur jaha lesion nahi dikhta usme non-lesional surgery kehte hai. Isme ek palliative surgery bhi hoti hai, ye surgery diet aur VNS ya vagal nerve stimulant ke hisab se bahut jyada complicated hoti hai lekin jo bacchon ke akdi baki cheezo se control nahi hoti usme iska faida ho sakta hai. To aaj maine apse bat ki iske bare mein ki drug resistant epilepsy kis tareeke se control karni chahye. Aapko aapke paediatric neurologist ke pass jana zaroori hai aur yeh treatment options vo aapke sath discuss karenge.

Agar aapko iske bare mein aur koi jankari chahye to aap lybrate hamare page pe visit kar sakte hai.

Thank you.

chat_icon

Ask a free question

Get FREE multiple opinions from Doctors

posted anonymously
doctor

Book appointment with top doctors for Epilepsy treatment

View fees, clinc timings and reviews
doctor

Treatment Enquiry

Get treatment cost, find best hospital/clinics and know other details