title: Low Glycemic Index Treatment in pediatric refractory epilepsy: the first Middle East report.
abstract: OBJECTIVE
  Intractable epilepsy is a challenging aspects of pediatric epilepsy. This study was conducted to determine the efficacy and tolerability of Low Glycemic Index Treatment (LGIT) in pediatric patients referred to a Children's Hospital in Iran with intractable epilepsy.
  
  
  METHODS
  We studied 42 children with refractory epilepsy aged between 1.5 and 17 years of age, from October 2009 to April 2011 in the pediatric neurology department of Mofid Children's Hospital. Patient information on clinical status, seizure type, and baseline frequency, blood and urine biochemistry, neuro-imaging and the EEG were collected. LGIT was initiated on an outpatient basis and the diet was composed of 65% fat, 25% protein and 10% carbohydrate (40-60 g), and the glycemic index of foods was limited to below 50.
  
  
  RESULTS
  84% of patients were categorized as having more than one seizure per day at study entry, with the remaining children as experiencing over one seizure per week. A greater than 50% seizure reduction was observed in 71.4% of the patients after the second week, in 73.8% at the end of the first month and in 77.8% at the end of the second month. In 30% of the patients a mild increase in blood urea nitrogen (BUN) was detected. The most important reasons for discontinuation of LGIT were restrictiveness, lack of satiation and excessive meat in this diet. No significant complications were observed during the administration of the diet.
  
  
  CONCLUSIONS
  LGIT is a safe and effective adjuvant antiepileptic therapy and may be used as an alternative to the ketogenic diet in conditions when this diet cannot be used.
authors.affiliation: Paediatric Neurology Research Center, Mofid Children's Hospital, Tehran, Iran; Department of Paediatric Neurology, Mofid Children's Hospital, Tehran, Iran.
authors.forename: Parvaneh
authors.initials: P
authors.lastname: Karimzadeh
authors.affiliation: Department of Paediatric Neurology, Mofid Children's Hospital, Tehran, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Sedighi
authors.affiliation: Department of Nutrition, Mofid Children's Hospital, Tehran, Iran. Electronic address: meheshti@gmail.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Beheshti
authors.affiliation: Paediatric Neurology Research Center, Mofid Children's Hospital, Tehran, Iran.
authors.forename: Enzollah
authors.initials: E
authors.lastname: Azargashb
authors.affiliation: Paediatric Neurology Research Center, Mofid Children's Hospital, Tehran, Iran; Department of Paediatric Neurology, Mofid Children's Hospital, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ghofrani
authors.affiliation: Clinical Research Development Center, Mofid Children's Hospital, Tehran, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Abdollahe-Gorgi
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D001806:Blood Urea Nitrogen; D002648:Child; D002675:Child, Preschool; D055423:Diet, Ketogenic / Q000379:methods*; D004569:Electroencephalography; D004827:Epilepsy / Q000097:blood* / Q000178:diet therapy* / Q000188:drug therapy; D005260:Female; D038321:Glycemic Index; D006801:Humans; D007223:Infant; D008297:Male; D008877:Middle East; D053284:Polyunsaturated Alkamides / Q000627:therapeutic use; D011422:Propionates / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D053284:Polyunsaturated Alkamides; D011422:Propionates; C037512:3,4-dichlorophenyl propenylisobutylamide
keywords: Children; Ketogenic diet; Low Glycemic Index Treatment; Refractory epilepsy; Seizure reduction