Use of the Modified Atkins Diet for Treatment of Refractory Drug Resistant Childhood Epilepsy

In the January early view, Epilepsia, Drs. Sharma and colleagues from the Division of Pediatric Neurology, Department of Pediatrics at the All-India Institute of Medical Sciences in New Delhi, India present the results from a randomized controlled trial to assess the effectiveness of a modified Atkins diet for treatment of drug resistant epilepsy in children. The authors aimed to study how well a modified Atkins diet works in children. They enrolled children between the ages of 2-14 who had daily seizures and were on at least three other seizure medications. These kids were randomized to receive either a modified Atkins diet or no diet intervention for three months while remaining on their medications. The researchers measured seizure control at three months as well as side effects based on reports from the parents.

A total of 102 children were enrolled, 50 in the diet group and 52 in the non-diet group. Four of the children stopped the diet before the three month period and three children in the group that were not on the diet did not follow-up. The mean seizure frequency at three months was less in the diet group compared to those in the non-diet group. The proportion of kids who had more than a 90% seizure reduction was 30% . Moreover, the responder rate – defined as 50% seizure reduction was 52% for those kids treated with diet . Constipation was the most commonly reported side effect. The authors concluded that the modified Atkins diet is an effective and well tolerated treatment in children with drug resistant epilepsy.

This study shows how the modified Atkins diet is both effective and safe. This study included children with all types of syndromes and seizure types suggesting a benefit for all seizure conditions. Clearly the modified Atkins diet is an important choice for consideration for therapy in individuals especially children who have drug resistant epilepsy and should be offered as a standard of care for all children.