饮食与癫痫——临床的误区和困惑_Journal of Epilepsy

Authors：

 余年 ,  狄晴

南京医科大学附属脑科医院神经内科（南京，210029）;

Corresponding author：

狄晴, Email: diqing@medmail.com.cn

Keywords：

癫痫; 饮食; 维生素

DOI：

10.7507/2096-0247.20160062

Video：

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饮食禁忌是所有癫痫患者及家属、医生关心的话题之一。癫痫患者饮食受癫痫发作频率、服用抗癫痫药物（AEDs）以及当地经济水平和文化习俗影响。为进一步全面了解癫痫患者饮食禁忌，现将对饮食与癫痫相关文献进行综述，为我国临床医生提供参考，以便科学指导癫痫患者及其家属合理膳食，并为在我国开展相关研究提供线索。在作出癫痫患者科学膳食指南之前，需要对癫痫人群营养、膳食情况进行规范系统的流行病学调查，尤其是人口众多、饮食文化背景特殊的中国人群。

Citation： 余年, 狄晴. 饮食与癫痫——临床的误区和困惑. Journal of Epilepsy, 2016, 2(4): 349-354. doi: 10.7507/2096-0247.20160062 Copy

1.	Collins PY, Patel V, Joestl SS, et al. Grand challenges in global mental health. Nature, 2011, 475(7354):27-30.
2.	Asadi-Pooya AA, Ghaffari A. Do patients with epilepsy believe they need specific dietary restrictions?. Epilepsy Behav, 2004, 5(6):945-948.
3.	Asadi-Pooya AA, Sperling MR. Do foods precipitate seizures? A cross-cultural comparison. Epilepsy Behav, 2007, 7(3):450-453.
4.	Ferlisi M, Shorvon S. Seizure precipitants (triggering factors) in patients with epilepsy. Epilepsy Behav, 2014, 14(5):101-105.
5.	Asadi-Pooya AA, Hossein-Zade A. What do nurses and physicians think about the need for specific dietary restrictions in patients with epilepsy?. Epilepsy Behav, 2005, 6(4):604-606.
6.	Enginar N, Nurten A, Türkmen AZ, et al. Scopolamine-induced convulsions in fasted animals after food intake:sensitivity of C57BL/6J mice and Sprague-Dawley rats. Epilepsy research, 2015, 112(7):150-153.
7.	Crepin S, Godet B, Chassain B, et al. Malnutrition and epilepsy:a two-way relationship. Clin Nutr, 2009, 28(3):219-225.
8.	Gordon KE, Dooley JM. Food insecurity and epilepsy in a nationally representative sample. Epilepsy & Behavior, 2015, 43(8):139-142.
9.	Bhalla D, Chea K, Hun C, et al. Population-based study of epilepsy in Cambodia associated factors, measures of impact, stigma, quality of life, knowledge-attitude-practice, and treatment gap. PLOS One, 2012, 7(10):e46296.
10.	Frediani T, Lucarelli S, Pelliccia A, et al. Allergy and childhood epilepsy:a close relationship?. Acta Neurol Scand, 2001, 104(6):349-352.
11.	Stevens H. Allergy and epilepsy. Epilepsia, 1965, 6(3):205-216.
12.	Bhagavan HN, Coursin DB, Stewart CN. Monosodium glutamateinduces convulsive disorders in rats. Nature, 1971, 232(11):275-276.
13.	Egger J, Carter CM, Soothill JF, et al. Oligoantigenic diet treatment of children with epilepsy and migraine. J Pediatr, 1989, 114(1):51-58.
14.	Miwa H, Iijima M, Taraka S, et al. Generalized convulsionsafter consuming a large amount of gingko nuts. Epilepsia, 2001, 42(8):280-281.
15.	Tsai MH, Chang WN, Lui CC, et al. Status epilepticus induced bystar fruit intoxication in patients with chronic renal disease. Seizure, 2005, 14(8):521-525.
16.	Gallagher BB, Prichard JW, Glaser GH. Seizure threshold andexcess dietary amino acids. Neurology, 1968, 18(2):208-212.
17.	Grant EC.Food allergies and migraine. Lancet, 1979, 1(8123):966-999.
18.	Fong SY, Gao Q, Zuo Z. Interaction of carbamazepine with herbs, dietary supplements, and food:a systematic review. Evid Based Complement Alternat Med, 2013, 20(3):898261.
19.	Garg SK, Kumar N, Bhargava VK, et al. Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy. Clin Pharmacol Ther, 1998, 64(3):286-288.
20.	Botez MI, Botez T, Ross-Chouinard A, et al. Thiamine and folate treatment of chronic epileptic patients:a controlled study with the Wechsler IQ scale. Epilepsy Res, 1993, 16(2):157-163.
21.	Botez MI, Joyal C, Maag U, et al. Cerebrospinal fluid and blood thiamine concentrations in phenytoin-treated epileptics. Neurol Sci, 1982, 9(1):37-39.
22.	Plecko B. Pyridoxine and pyridoxalphosphate-dependent epilepsies. Handb Clin Neurol, 2013, 113(10):1811-1887.
23.	Ohtahara S, Yamatogi Y, Ohtsuka Y. Vitamin B6 treatment of intractable seizures. Brain Dev, 2011, 33(9):783-789.
24.	Malbora B, Yuksel D, Aksoy A, et al. Two infants with infantile spasms associated with vitamin B12 deficiency. Pediatr Neurol, 2014, 51(1):144-146.
25.	Krishnamoorthy G, Nair R, Sundar U, et al. Early predisposition to osteomalacia in Indian adults on phenytoin or valproate monotherapy and effective prophylaxis by simultaneous supplementation with calcium and 25-hydroxy vitamin D at recommended daily allowance dosage:a prospective study. Neurol India, 2010, 58(2):213-219.
26.	Miller M, Weber M, Valdes EV, et al. Changes in serum calcium, phosphorus, and magnesium levels in captive ruminants affected by diet manipulation. J Zoo WildMed, 2010, 41(3):404-408.
27.	Nagarjunakonda S, Amalakanti S, Uppala V, et al. Vitamin D in epilepsy:vitamin D levels in epilepsy patients, patients on antiepileptic drug polytherapy and drug-resistant epilepsy sufferers. European Journal of Clinical Nutrition, 2016, 70(1):140-142.
28.	Schaaf M, Payne CA. Effect of diphenylhydantoin and phenobarbital on overt and latent tetany. N Engl J Med, 1966, 274(22):1228-1233.
29.	谢燕丽.硫酸镁用于子痫前期-子痫的再评价.国际妇产科学杂志, 2011, 38(3):182-185.
30.	Castro-Gago M, Pérez-Gay L, Gómez-Lado C, et al. The influence of valproic acid and carbamazepine treatment on serum biotin and zinc levels and on biotinidase activity. J Child Neurol, 2011, 26(12):1522-1524.
31.	Miyamoto K, Ichikawa J, Okuya M, et al. Too little water or too much:hyponatremia due to excess fluid intake. Acta Paediatr, 2012, 101(9):e390-391.
32.	Raju GB, Behari M, Prasad K, et al. Randomized, double-blind, placebo-controlled, clinical trial of D-alpha-tocopherol (vitamin E) as add-on therapy in uncontrolled epilepsy. Epilepsia, 1994, 35(2):368-372.
33.	Scott JM, Weir DG. Drug-induced megaloblastic change. Clin Haematol, 1980, 9(3):587-606.
34.	DeVivo DC, Bohan TP, Coulter DL, et al. L-carnitine supplementation in childhood epilepsy:current perspectives. Epilepsia, 1998, 39(11):1216-1225.
35.	Terra VC, Arida RM, Rabello GM, et al.The utility of omega-3 fatty acids in epilepsy:more than just a farmed tilapia!. Arq Neuropsiquiatr. 2011, 69(1):118-121.
36.	Reda DMA, Abd-El-Fatah NK, Omar TESI, et al. Fish oil intake and seizure control in children with medically resistant epilepsy. North American Journal of Medical Sciences, 2015, 7(7):317.
37.	Carr C. Eat to Beat Seizures:the high-fat ketogenic diet can help stop seizures in hard-to-treat epilepsy. Doctors and dietitians explain how it works and how it is implemented. Neurology Now, 2015, 11(5):18-29.
38.	Kessler SK, Neal EG, Camfield CS, et al. Dietary therapies for epilepsy:future research.Epilepsy Behav, 2011, 22(1):17-22.
39.	Kossoff EH, Dorward JL, Turner Z, et al. Prospective study of the ModifiedAtkins Diet in combination with a ketogenic liquid supplement during the initialmonth. J Child Neurol, 2011, 26(7):147-151.
40.	Aldarmaa J, Liu Z, Long J, et al. Anti-convulsant effect and mechanism of Astragalus mongholicus extract in vitro and in vivo:protection against oxidative damageand mitochondrial dysfunction.Neurochem Res, 2010, 35(1):33-41.
41.	Jalsrai A, Grecksch G, Becker A. Evaluation of the effects of astragalus mongholicus bunge saponin extract on central nervous system functions. J Ethnopharmacol, 2010, 131(3):544-549.
42.	Zhang Z, Lian XY, Li S, et al.Characterization of chemical ingredients and anticonvulsant activity of american skullcap (Scutellaria lateriflora). Phytomedicine, 2009, 16(5):485-493.
43.	Kulkarni S K, Dhir A. Berberine:a plant alkaloid with therapeutic potential for central nervous system disorders. Phytotherapy Research, 2010, 24(3):317-324.
44.	Bhutada, Pravinkumar. Anticonvulsant activity of berberine, an isoquinoline alkaloid in mice. Epilepsy & Behavior, 2010, 18 (3):207-210.
45.	刘新红, 余年, 狄晴, 等.小檗碱对癫痫大鼠脑组织P-糖蛋白表达的影响.临床神经病学杂志, 2013, 26(3):191-194.
46.	李世绰.认识癫痫, 战胜癫痫.癫痫杂志, 2015, 1(1):2-5.

1. Collins PY, Patel V, Joestl SS, et al. Grand challenges in global mental health. Nature, 2011, 475(7354):27-30.
2. Asadi-Pooya AA, Ghaffari A. Do patients with epilepsy believe they need specific dietary restrictions?. Epilepsy Behav, 2004, 5(6):945-948.
3. Asadi-Pooya AA, Sperling MR. Do foods precipitate seizures? A cross-cultural comparison. Epilepsy Behav, 2007, 7(3):450-453.
4. Ferlisi M, Shorvon S. Seizure precipitants (triggering factors) in patients with epilepsy. Epilepsy Behav, 2014, 14(5):101-105.
5. Asadi-Pooya AA, Hossein-Zade A. What do nurses and physicians think about the need for specific dietary restrictions in patients with epilepsy?. Epilepsy Behav, 2005, 6(4):604-606.
6. Enginar N, Nurten A, Türkmen AZ, et al. Scopolamine-induced convulsions in fasted animals after food intake:sensitivity of C57BL/6J mice and Sprague-Dawley rats. Epilepsy research, 2015, 112(7):150-153.
7. Crepin S, Godet B, Chassain B, et al. Malnutrition and epilepsy:a two-way relationship. Clin Nutr, 2009, 28(3):219-225.
8. Gordon KE, Dooley JM. Food insecurity and epilepsy in a nationally representative sample. Epilepsy & Behavior, 2015, 43(8):139-142.
9. Bhalla D, Chea K, Hun C, et al. Population-based study of epilepsy in Cambodia associated factors, measures of impact, stigma, quality of life, knowledge-attitude-practice, and treatment gap. PLOS One, 2012, 7(10):e46296.
10. Frediani T, Lucarelli S, Pelliccia A, et al. Allergy and childhood epilepsy:a close relationship?. Acta Neurol Scand, 2001, 104(6):349-352.
11. Stevens H. Allergy and epilepsy. Epilepsia, 1965, 6(3):205-216.
12. Bhagavan HN, Coursin DB, Stewart CN. Monosodium glutamateinduces convulsive disorders in rats. Nature, 1971, 232(11):275-276.
13. Egger J, Carter CM, Soothill JF, et al. Oligoantigenic diet treatment of children with epilepsy and migraine. J Pediatr, 1989, 114(1):51-58.
14. Miwa H, Iijima M, Taraka S, et al. Generalized convulsionsafter consuming a large amount of gingko nuts. Epilepsia, 2001, 42(8):280-281.
15. Tsai MH, Chang WN, Lui CC, et al. Status epilepticus induced bystar fruit intoxication in patients with chronic renal disease. Seizure, 2005, 14(8):521-525.
16. Gallagher BB, Prichard JW, Glaser GH. Seizure threshold andexcess dietary amino acids. Neurology, 1968, 18(2):208-212.
17. Grant EC.Food allergies and migraine. Lancet, 1979, 1(8123):966-999.
18. Fong SY, Gao Q, Zuo Z. Interaction of carbamazepine with herbs, dietary supplements, and food:a systematic review. Evid Based Complement Alternat Med, 2013, 20(3):898261.
19. Garg SK, Kumar N, Bhargava VK, et al. Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy. Clin Pharmacol Ther, 1998, 64(3):286-288.
20. Botez MI, Botez T, Ross-Chouinard A, et al. Thiamine and folate treatment of chronic epileptic patients:a controlled study with the Wechsler IQ scale. Epilepsy Res, 1993, 16(2):157-163.
21. Botez MI, Joyal C, Maag U, et al. Cerebrospinal fluid and blood thiamine concentrations in phenytoin-treated epileptics. Neurol Sci, 1982, 9(1):37-39.
22. Plecko B. Pyridoxine and pyridoxalphosphate-dependent epilepsies. Handb Clin Neurol, 2013, 113(10):1811-1887.
23. Ohtahara S, Yamatogi Y, Ohtsuka Y. Vitamin B6 treatment of intractable seizures. Brain Dev, 2011, 33(9):783-789.
24. Malbora B, Yuksel D, Aksoy A, et al. Two infants with infantile spasms associated with vitamin B12 deficiency. Pediatr Neurol, 2014, 51(1):144-146.
25. Krishnamoorthy G, Nair R, Sundar U, et al. Early predisposition to osteomalacia in Indian adults on phenytoin or valproate monotherapy and effective prophylaxis by simultaneous supplementation with calcium and 25-hydroxy vitamin D at recommended daily allowance dosage:a prospective study. Neurol India, 2010, 58(2):213-219.
26. Miller M, Weber M, Valdes EV, et al. Changes in serum calcium, phosphorus, and magnesium levels in captive ruminants affected by diet manipulation. J Zoo WildMed, 2010, 41(3):404-408.
27. Nagarjunakonda S, Amalakanti S, Uppala V, et al. Vitamin D in epilepsy:vitamin D levels in epilepsy patients, patients on antiepileptic drug polytherapy and drug-resistant epilepsy sufferers. European Journal of Clinical Nutrition, 2016, 70(1):140-142.
28. Schaaf M, Payne CA. Effect of diphenylhydantoin and phenobarbital on overt and latent tetany. N Engl J Med, 1966, 274(22):1228-1233.
29. 谢燕丽.硫酸镁用于子痫前期-子痫的再评价.国际妇产科学杂志, 2011, 38(3):182-185.
30. Castro-Gago M, Pérez-Gay L, Gómez-Lado C, et al. The influence of valproic acid and carbamazepine treatment on serum biotin and zinc levels and on biotinidase activity. J Child Neurol, 2011, 26(12):1522-1524.
31. Miyamoto K, Ichikawa J, Okuya M, et al. Too little water or too much:hyponatremia due to excess fluid intake. Acta Paediatr, 2012, 101(9):e390-391.
32. Raju GB, Behari M, Prasad K, et al. Randomized, double-blind, placebo-controlled, clinical trial of D-alpha-tocopherol (vitamin E) as add-on therapy in uncontrolled epilepsy. Epilepsia, 1994, 35(2):368-372.
33. Scott JM, Weir DG. Drug-induced megaloblastic change. Clin Haematol, 1980, 9(3):587-606.
34. DeVivo DC, Bohan TP, Coulter DL, et al. L-carnitine supplementation in childhood epilepsy:current perspectives. Epilepsia, 1998, 39(11):1216-1225.
35. Terra VC, Arida RM, Rabello GM, et al.The utility of omega-3 fatty acids in epilepsy:more than just a farmed tilapia!. Arq Neuropsiquiatr. 2011, 69(1):118-121.
36. Reda DMA, Abd-El-Fatah NK, Omar TESI, et al. Fish oil intake and seizure control in children with medically resistant epilepsy. North American Journal of Medical Sciences, 2015, 7(7):317.
37. Carr C. Eat to Beat Seizures:the high-fat ketogenic diet can help stop seizures in hard-to-treat epilepsy. Doctors and dietitians explain how it works and how it is implemented. Neurology Now, 2015, 11(5):18-29.
38. Kessler SK, Neal EG, Camfield CS, et al. Dietary therapies for epilepsy:future research.Epilepsy Behav, 2011, 22(1):17-22.
39. Kossoff EH, Dorward JL, Turner Z, et al. Prospective study of the ModifiedAtkins Diet in combination with a ketogenic liquid supplement during the initialmonth. J Child Neurol, 2011, 26(7):147-151.
40. Aldarmaa J, Liu Z, Long J, et al. Anti-convulsant effect and mechanism of Astragalus mongholicus extract in vitro and in vivo:protection against oxidative damageand mitochondrial dysfunction.Neurochem Res, 2010, 35(1):33-41.
41. Jalsrai A, Grecksch G, Becker A. Evaluation of the effects of astragalus mongholicus bunge saponin extract on central nervous system functions. J Ethnopharmacol, 2010, 131(3):544-549.
42. Zhang Z, Lian XY, Li S, et al.Characterization of chemical ingredients and anticonvulsant activity of american skullcap (Scutellaria lateriflora). Phytomedicine, 2009, 16(5):485-493.
43. Kulkarni S K, Dhir A. Berberine:a plant alkaloid with therapeutic potential for central nervous system disorders. Phytotherapy Research, 2010, 24(3):317-324.
44. Bhutada, Pravinkumar. Anticonvulsant activity of berberine, an isoquinoline alkaloid in mice. Epilepsy & Behavior, 2010, 18 (3):207-210.
45. 刘新红, 余年, 狄晴, 等.小檗碱对癫痫大鼠脑组织P-糖蛋白表达的影响.临床神经病学杂志, 2013, 26(3):191-194.
46. 李世绰.认识癫痫, 战胜癫痫.癫痫杂志, 2015, 1(1):2-5.

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