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Peer-reviewedCC BYJPGN reports

Stepwise administration of de novo ketogenic parenteral nutrition for refractory epilepsy during prolonged bowel rest following duodenal perforation

  • Zaid Sheikh1
  • Sarika Sewak2
  • Danielle N. Mein2
  • Joyce H. Matsumoto3
  • Alvin P. Chan4
4 affiliations
  1. 1Division of Pediatric Gastroenterology, Department of Pediatrics Holtz Children's Hospital, UM Miami Florida USA
  2. 2Department of Clinical Nutrition UCLA Mattel Children's Hospital, UCLA Los Angeles California USA
  3. 3Division of Pediatric Neurology, Department of Pediatrics UCLA Mattel Children's Hospital, UCLA Los Angeles California USA
  4. 4Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics UCLA Mattel Children's Hospital, UCLA Los Angeles California USA
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Abstract

Ketogenic diet is an established therapy for pediatric patients with intractable epilepsy. By shifting energy metabolism from glucose to fat, the diet increases the production of ketone bodies, which alters neuronal excitability and modulates neurotransmitter signaling, thereby raising the seizure threshold. In critically ill children who are unable to tolerate enteral feeds, ketogenic parenteral nutrition (kPN) offers a valuable alternative to the standard ketogenic diet. However, its use has been underutilized and challenged by a lack of standardized protocols. In this report, we present a stepwise approach for initiating kPN in a ketogenic diet‐naive toddler with refractory epilepsy and bowel dysfunction.

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Cite

BibTeXRIS
BibTeX
@article{sheikh2026stepwise,
  title = {{Stepwise administration of de novo ketogenic parenteral nutrition for refractory epilepsy during prolonged bowel rest following duodenal perforation}},
  author = {Zaid Sheikh and Sarika Sewak and Danielle N. Mein and Joyce H. Matsumoto and Alvin P. Chan},
  journal = {JPGN reports},
  year = {2026},
  month = oct,
  doi = {10.1002/jpr3.70293},
  url = {https://europepmc.org/article/PMC/PMC13721025},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Stepwise administration of de novo ketogenic parenteral nutrition for refractory epilepsy during prolonged bowel rest following duodenal perforation
AU  - Zaid Sheikh
AU  - Sarika Sewak
AU  - Danielle N. Mein
AU  - Joyce H. Matsumoto
AU  - Alvin P. Chan
PY  - 2026
DA  - 2026/10/30
JO  - JPGN reports
DO  - 10.1002/jpr3.70293
UR  - https://europepmc.org/article/PMC/PMC13721025
AB  - Ketogenic diet is an established therapy for pediatric patients with intractable epilepsy. By shifting energy metabolism from glucose to fat, the diet increases the production of ketone bodies, which alters neuronal excitability and modulates neurotransmitter signaling, thereby raising the seizure threshold. In critically ill children who are unable to tolerate enteral feeds, ketogenic parenteral nutrition (kPN) offers a valuable alternative to the standard ketogenic diet. However, its use has been underutilized and challenged by a lack of standardized protocols. In this report, we present a stepwise approach for initiating kPN in a ketogenic diet‐naive toddler with refractory epilepsy and bowel dysfunction.
SN  - 2691-171X
ER  -