Nutrición basada en la evidencia en las enfermedades neurológicas

Neurological disease causes considerable morbidity in developed countries and frequently leads to alterations in the level of consciousness or in the mechanisms of swallowing, which may necessitate artificial nutritional support. The present review aims to evaluate nutritional support in acute cerebral vascular disease, dementia and amyotrophic lateral sclerosis, as well as the utility of a ketogenic diet in the treatment of epilepsy, based on the best available scientific evidence. A literature search was performed in Medline (PubMed) and in the Cochrane Library Plus in Spanish. Randomized clinical studies, systematic reviews, and metaanalyses were selected. There are few prospective randomized studies on nutritional support in neurological diseases. The FOOD study shows that the nasogastric tube is a better route of administration than percutaneous endoscopic gastrostomy for enteral nutrition in the first month after stroke. In the case of dementia and other neurodegenerative diseases, the available evidence is weak. There are no reliable data from randomized controlled trials that support the use of ketogenic diets in patients with epilepsy.