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Various indications for a modified Atkins diet in intractable childhood epilepsy
Yoon Mi Kim1, Varsha Viranchi Vaidya, Timur Khusainov
1Division of Pediatric Neurology, Department of Pediatrics, Pediatric Epilepsy Clinic, Severance Children's Hospital, Epilepsy Research Institute, Yonsei University College of Medicine, Seodaemun-Gu, Seoul, Republic of Korea.
Insights
The modified Atkins diet (MAD) is a well-tolerated option for children with intractable epilepsy, offering favorable seizure outcomes and potentially substituting the ketogenic diet (KD) for those who cannot tolerate it.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Dietary Therapies
Background:
- Intractable epilepsy in children poses significant management challenges.
- Dietary therapies, such as the ketogenic diet (KD), are established treatments.
- The modified Atkins diet (MAD) offers a less restrictive alternative.
Purpose of the Study:
- To evaluate the efficacy and tolerability of the modified Atkins diet (MAD) in children with intractable epilepsy.
- To assess the MAD as a potential substitute for the classic ketogenic diet (KD).
Main Methods:
- Retrospective review of 20 children (aged 2-17) with intractable epilepsy who underwent the MAD between 2008 and 2010.
- Outcome measures included seizure frequency, adverse reactions, and diet tolerability.
Main Results:
- Nine patients achieved favorable seizure outcomes (over 50% reduction) or completed diet therapy.
- Two patients with rare mitochondrial disorders successfully maintained the MAD long-term.
- The MAD was effective in maintaining seizure control for some patients who found the KD too restrictive or experienced adverse events.
Conclusions:
- The modified Atkins diet (MAD) is well-tolerated for long-term use in pediatric epilepsy.
- MAD can be a successful alternative to the ketogenic diet (KD) for patients who benefit from KD but struggle with adherence or side effects.
Purpose:
We reviewed retrospectively our experiences with children with intractable epilepsy who were indicated for a modified Atkins diet (MAD).
Methods:
Twenty children (8 female, 12 male) who were aged 2-17 years with intractable epilepsy and tried the MAD between September 2008 and December 2010 were enrolled. Outcome measures included seizure frequency, adverse reactions and tolerability of the diet.
Results:
Finally 9 patients maintained the MAD with favorable seizure outcomes (a reduction of seizure frequency by over 50%) or successfully completed the diet therapy. Two patients who required a long-term trial of the diet therapy respectively due to Leigh's syndrome and uncategorized mitochondrial cytopathy derived from cytochrome c oxidase defect, respectively, successfully maintained the diet treatment without any significant complications. In 7 patients, the ketogenic diet (KD) was not only effective but also too restrictive or caused serious unwanted events. Five of them maintained the seizure outcome previously achieved by the KD with the MAD. Ten patients began the MAD because they were reluctant to start the KD. Unfortunately, only 2 patients maintained the MAD with favorable seizure outcomes. One patient who chose the MAD to bridge the KD and complete discontinuation of the treatment successfully completed the diet therapy.
Conclusion:
A long-term treatment with the MAD was well tolerated. Moreover, the MAD can successfully substitute the classic KD in patients who showed improvement in seizure outcomes by the KD but could not tolerate it.
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