title: Will seizure control improve by switching from the modified Atkins diet to the traditional ketogenic diet?
abstract: It has been reported that children can maintain seizure control when the ketogenic diet (KD) is transitioned to the less-restrictive modified Atkins diet (MAD). What is unknown, however, is the likelihood of additional seizure control from a switch from the MAD to the KD. Retrospective information was obtained from 27 patients who made this dietary change from four different institutions. Ten (37%) patients had ≥10% additional seizure reduction with the KD over the MAD, of which five became seizure-free. The five children who did not improve on the MAD failed to improve when transitioned to the KD. A higher incidence of improvement with the KD occurred for those with myoclonic-astatic epilepsy (70% vs. 12% for all other etiologies, p = 0.004), including all who became seizure-free. These results suggest that the KD probably represents a "higher dose" of dietary therapy than the MAD, which may particularly benefit those with myoclonic-astatic epilepsy.
authors.affiliation: Neurology, The Johns Hopkins University, Baltimore, Maryland, USA. ekossoff@jhmi.edu
authors.forename: Eric H
authors.initials: EH
authors.lastname: Kossoff
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Bosarge
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Miranda
authors.forename: Adelheid
authors.initials: A
authors.lastname: Wiemer-Kruel
authors.forename: Hoon Chul
authors.initials: HC
authors.lastname: Kang
authors.forename: Heung Dong
authors.initials: HD
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D003431:Cross-Cultural Comparison; D050528:Diet, Carbohydrate-Restricted / Q000379:methods* / Q000706:statistics & numerical data; D055423:Diet, Ketogenic / Q000379:methods* / Q000706:statistics & numerical data; D004831:Epilepsies, Myoclonic / Q000178:diet therapy; D004828:Epilepsies, Partial / Q000178:diet therapy; D004829:Epilepsy, Generalized / Q000178:diet therapy*; D005260:Female; D006801:Humans; D007662:Ketosis / Q000652:urine; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome