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Modified Atkins Diet vs Low Glycemic Index Treatment for Drug-Resistant Epilepsy in Children: An Open Label,
Surbhi Gupta1, Surekha Dabla2, Jaya Shankar Kaushik1
1Department of Pediatrics, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Insights
The modified Atkins diet (mAD) and low glycemic index treatment (LGIT) showed comparable seizure freedom rates in children with drug-resistant epilepsy. LGIT demonstrated a greater reduction in seizure frequency, though the effect was small.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Dietary Interventions
Background:
- Drug-resistant epilepsy affects children significantly, necessitating alternative treatment strategies.
- Dietary therapies, such as the modified Atkins diet (mAD) and low glycemic index treatment (LGIT), are recognized options.
Purpose of the Study:
- To compare the efficacy of mAD versus LGIT in pediatric patients with drug-resistant epilepsy.
- To evaluate seizure freedom, seizure reduction, and adverse effects of these two dietary interventions.
Main Methods:
- A randomized, open-label, controlled trial was conducted with children aged 6 months to 14 years.
- Participants received either mAD or LGIT as an add-on therapy to their existing antiseizure medications.
- Primary outcome was seizure freedom at 12 weeks; secondary outcomes included seizure reduction and adverse events.
Main Results:
- Seizure freedom at 12 weeks was comparable between the mAD and LGIT groups (16.6% vs 6.6%).
- A significantly higher proportion of children achieved >50% seizure reduction with LGIT compared to mAD (73.3% vs 43.3%).
- Lethargy was the most common adverse effect reported in both dietary groups.
Conclusions:
- In this limited sample size study, mAD and LGIT demonstrated comparable efficacy in achieving seizure freedom in children with drug-resistant epilepsy.
- LGIT showed a trend towards greater seizure reduction, warranting further investigation.
Objective:
To compare the efficacy of the modified Atkins diet (mAD) and low glycemic index treatment (LGIT) among children with drug-resistant epilepsy.
Design:
Randomized, open labelled, controlled clinical trial.
Setting:
Tertiary care referral center.
Participants:
Children aged 6 months to 14 years with drug-resistant epilepsy.
Intervention:
mAD (n=30) or LGIT (n=30) as an add-on to the ongoing antiseizure drugs.
Main Outcome Measures:
Proportion of children who achieved seizure freedom as defined by complete cessation of seizure at 12 weeks as primary outcome measure. Secondary outcome measures were proportion of children who achieved >50% and >90% seizure reduction at 12 weeks, and adverse effects of the two therapies.
Results:
Of the 60 recruited children, 3 in the mAD group, and 3 in LGIT group were lost to follow-up. The proportion of children with seizure freedom [16.6% vs 6.6%; relative risk reduction (RRR) (95% CI), 1.5 (-10.9, 0.5); P=0.42] and >90% seizure reduction [30% vs 13.3%; RRR, -1.2 (-5.5, 0.2); P=0.21] was comparable between the mAD and LGIT group at 12 weeks. The proportion of children with >50% seizure reduction was significantly higher at 12 weeks among those who received LGIT as compared to the mADgroup [73.3% vs 43.3%; RRR (95% CI) 0.4 (0.1-0.6); P=0.03] although the effect size was small. The diet was well tolerated with lethargy being the most common adverse effect in children in mAD (53.3%) and LGIT (66.7%) groups.
Conclusions:
The present study with limited sample size shows that seizure freedom at 12 weeks was comparable between mAD and LGIT for the treatment of drug-resistant epilepsy.
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