A pilot trial with modified Atkins' diet in adult patients with refractory epilepsy.
OBJECTIVE
At Ghent University Hospital, the feasibility and efficacy of the modified Atkins' diet was evaluated in adult patients with refractory epilepsy. The Atkins' diet restricts carbohydrate intake and was originally designed for weight loss.


METHODS
During a 6-month trial period, a carbohydrate restriction of 20 g/day was in place. During a 36 h hospital admission, patients were instructed about the diet. Patients underwent clinical neurological testing, EEG, ECG, blood and urine analyses and mood evaluation before and during the trial. Seizure frequency and side effects were recorded in seizure diaries and followed up at monthly clinic visits.


RESULTS
Eight patients were included in the study. Three out of eight patients followed the diet for 6 months. One out of three patients showed a >50% seizure reduction, 1/3>30%, and 1/3<30%. Side effects such as constipation and diarrhoea were mild and occurred mainly during the initial week of the diet. Patients reported improved concentration and well being. This was confirmed by improved scores on the Beck Depression Inventory Scale.


CONCLUSIONS
This pilot study shows that the modified Atkins' diet is feasible in an adult population, and that seizure frequency reduction is possible. The results need to be confirmed in larger prospective, controlled studies with comparison groups.
Carrette
Evelien
E
Reference Center for Refractory Epilepsy, Department of Neurology, Ghent University Hospital, 1K12IA, 185 De Pintelaan, B-9000 Gent, Belgium. Evelien.Carrette@UGent.be
Vonck
Kristl
K
de Herdt
Veerle
V
Dewaele
Isabelle
I
Raedt
Robrecht
R
Goossens
Lut
L
Van Zandijcke
Michel
M
Wadman
Wytse
W
Thadani
Vijay
V
Boon
Paul
P
D000328:Adult; D000339:Affect / Q000502:physiology; D000927:Anticonvulsants / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D050528:Diet, Carbohydrate-Restricted / Q000009:adverse effects; D004351:Drug Resistance; D004562:Electrocardiography; D004569:Electroencephalography; D004827:Epilepsy / Q000178:diet therapy* / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D007659:Ketones / Q000097:blood / Q000652:urine; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012640:Seizures / Q000503:physiopathology
D000927:Anticonvulsants; D001786:Blood Glucose; D007659:Ketones; D008055:Lipids