Advertisement

Efficacy and tolerability of modified Atkins diet in Japanese children with medication-resistant epilepsy

      Abstract

      Ten Japanese patients aged 1.5–17 years with medication-resistant epilepsy were placed on the modified Atkins diet (MAD) for 3 weeks during admission to our hospital. Dietary carbohydrate was restricted to 10 g per day. We studied the efficacy of the diet regarding the seizure frequency and tolerability of the diet at the end of the 3 weeks on the diet. Those who decided to continue the MAD at the time of discharge were followed up in the out-patient clinic to observe the effect of the diet on the seizure frequency. Three of the 10 patients could not continue the diet during the 3-week admission; one had rotavirus enterocolitis and the other 2 disliked the diet. Among the remaining 7 patients who could continue the diet for 3 weeks, 3 achieved the seizure reduction; 2 became seizure-free and 1 showed about 75% reduction in the seizure frequency within 10 days on the diet. All of these 3 patients continued the diet after the 3-week admission. The other 4 patients did not show a reduction of the seizure frequency by the end of the 3 weeks on the diet. Two of them discontinued the diet on discharge. The remaining 2 still continued the diet at home and one became seizure-free 3 months after the start of the diet. In total, 4 of 10 patients achieved >75% reduction in the seizure frequency, although relapse occurred in 2 of the patients, at 5 months and 2 years after seizure reduction, respectively. The MAD was effective and well-tolerated in children with medication-resistant epilepsy in Japan.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Brain and Development
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kossoff E.H.
        • McGrogan J.R.
        Worldwide use of the ketogenic diet.
        Epilepsia. 2005; 46: 280-289
        • Seo J.H.
        • Kim H.D.
        Cultural challenges in using the ketogenic diet in Asian countries.
        Epilepsia. 2008; 49: 50-52
        • Kossoff E.H.
        • Dorward J.L.
        The modified Atkins diet.
        Epilepsia. 2008; 49: 37-41
        • Kossoff E.H.
        • Krauss G.L.
        • McGrogan J.R.
        • McGrogan J.M.
        Efficacy of the Atkins diet as therapy for intractable epilepsy.
        Neurology. 2003; 61: 1788-1791
        • Kosoff E.H.
        • McGrogan J.R.
        • Bluml R.M.
        • Pillas D.J.
        • Rubenstein J.E.
        • Vining E.P.
        A modified Atkins diet is effective for the treatment of intractable pediatric epilepsy.
        Epilepsia. 2006; 47: 421-424
        • Kang H.C.
        • Lee H.S.
        • You S.J.
        • Kang du C.
        • Ko T.S.
        • Kim H.D.
        Use of a modified Atkins diet in intractable childhood epilepsy.
        Epilepsia. 2007; 48: 182-186
        • Weber S.
        • Molgaard C.
        • Taudorf K.
        • Uldall P.
        Modified Atkins diet to children and adolescents with medical intractable epilepsy.
        Seizure. 2009; 18: 237-240
        • Ito S.
        • Oguni H.
        • Ito Y.
        • Ishigaki K.
        • Ohinata J.
        • Osawa M.
        Modified Atkins diet therapy for a case with glucose transporter type 1 deficiency syndrome.
        Brain Dev. 2008; 30: 226-228
        • Oguni M.
        • Oguni H.
        • Ito S.
        • Ito Y.
        • Osawa M.
        Re-evaluation of ketogenic diet therapy for childhood refractory epilepsy.
        No to Hattatsu. 2009; 41 ([in Japanese]): 339-342
        • Zupec-Kania B.
        • Zupanc M.L.
        Long-term management of the ketogenic diet: seizure monitoring, nutrition, and supplementation.
        Epilepsia. 2008; 49: 23-26
        • Amari A.
        • Dahlquist L.
        • Kossoff E.H.
        • Vining E.P.G.
        • Trescher W.H.
        • Slifer K.J.
        Children with seizures exhibit preferences for foods compatible with ketogenic diet.
        Epilepsy Behav. 2007; 11: 98-104
        • Kossoff E.H.
        • Zupec-Kania B.A.
        • Amark P.E.
        • Ballaban-Gil K.R.
        • Christina Bergqvist A.G.
        • Blackford R.
        • et al.
        Optimal clinical management of children receiving the ketogenic diet: recommendations of the international Ketogenic Diet Study Group.
        Epilepsia. 2009; 50: 304-317
        • Kossoff E.H.
        • Turner Z.
        • Bluml R.M.
        • Pyzik P.L.
        • Vining E.P.
        A randomized, crossover comparison of daily carbohydrate limits using the modified Atkins diet.
        Epilepsy Behav. 2007; 10: 432-436
        • Kumada T.
        • Miyajima T.
        • Kimura N.
        • Saito K.
        • Shimomura H.
        • Oda N.
        • et al.
        Modified Atkins diet for the treatment of nonconvulsive status epilepticus in children.
        J Child Neurol. 2010; 25: 485-489
        • Kossoff E.H.
        • Laux L.C.
        • Blackford R.
        • Morrison P.F.
        • Pyzik P.L.
        • Hamdy R.M.
        • et al.
        When do seizures usually improve with the ketogenic diet?.
        Epilepsia. 2008; 49: 329-333