Use of the modified Atkins diet for treatment of refractory childhood epilepsy: A randomized controlled trial

Authors

  • Suvasini Sharma,

    1. Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
    Current affiliation:
    1. Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
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  • Naveen Sankhyan,

    1. Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
    Current affiliation:
    1. Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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  • Sheffali Gulati,

    Corresponding author
    • Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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  • Anuja Agarwala

    1. Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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  • This study was presented as a platform presentation at the “Joint Congress of the 12th International Child Neurology Congress and the 11th Asian and Oceanian Congress of Child Neurology.” held at Brisbane, Australia, 27 May–1 June 2012.

Address correspondence to Sheffali Gulati, Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India. E-mail: sheffaligulati@gmail.com

Summary

Purpose

The aim of this study was to evaluate the efficacy of the modified Atkins diet in a randomized controlled trial in children with refractory epilepsy.

Methods

Children aged 2–14 years who had daily seizures despite the appropriate use of at least three anticonvulsant drugs were enrolled. Children were randomized to receive either the modified Atkins diet or no dietary intervention for a period of 3 months. The ongoing anticonvulsant medications were continued unchanged in both the groups. Seizure control at 3 months was the primary end point. Analysis was intention to treat. Adverse effects of the diet were assessed by parental reports (ClinicalTrials.gov Identifier: NCT00836836).

Key Findings

Among a total of 102 children, 50 were in the diet group and 52 in the control group. Four children discontinued the diet before the study end point, and three children in the control group were lost to follow-up. The mean seizure frequency at 3 months, expressed as a percentage of the baseline, was significantly less in the diet group: 59 ± 54 (95% confidence interval [CI] 44–74.5) versus 95.5 ± 48 (95% CI 82–109), p = 0.003. The proportion of children with >90% seizure reduction (30% vs. 7.7%, p = 0.005) and >50% seizure reduction was significantly higher in the diet group (52% vs. 11.5%, p < 0.001). Constipation was the most common adverse effect among children on the diet (23, 46%).

Significance

The modified Atkins diet was found to be effective and well tolerated in children with drug-refractory epilepsy.

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