title: Diet Redux: Outcomes from Reattempting Dietary Therapy for Epilepsy.
abstract: The outcome for patients attempting dietary therapy for epilepsy a second time is unknown. Twenty-six subjects treated with the ketogenic diet as children who then began either the ketogenic diet or a Modified Atkins Diet (MAD) at least 6 months later were evaluated. The mean age at the first diet trial was 5.6 years and at the second diet trial was 11.5 years. Most restarted dietary therapy because of persistent seizures (65%) or recurrence after seizure freedom (19%). Overall, 77% had a ≥50% seizure reduction with the first diet, and 50% with the second diet, P = .04. Individual subject responses were largely similar, with 14 (54%) having identical seizure reduction both times, 9 worse (35%) with the second attempt, and 3 (16%) improved. The second diet trial was more likely to lead to >50% seizure reduction if the first trial was started at a later age (7.4 vs 3.9 years, P = .04).
authors.affiliation: Johns Hopkins Hospital, Baltimore, MD, USA ekossoff@jhmi.edu.
authors.forename: Eric H
authors.initials: EH
authors.lastname: Kossoff
authors.affiliation: Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Doerrer
authors.affiliation: University of South Florida, Saint Petersburg, FL, USA.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Winesett
authors.affiliation: Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Zahava
authors.initials: Z
authors.lastname: Turner
authors.affiliation: Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Bobbie J
authors.initials: BJ
authors.lastname: Henry
authors.affiliation: All Children's Hospital, St. Petersburg, FL, USA.
authors.forename: Stacey
authors.initials: S
authors.lastname: Bessone
authors.affiliation: Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Stanfield
authors.affiliation: Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Mackenzie C
authors.initials: MC
authors.lastname: Cervenka
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D050528:Diet, Carbohydrate-Restricted; D055423:Diet, Ketogenic; D000069279:Drug Resistant Epilepsy / Q000178:diet therapy* / Q000503:physiopathology; D004829:Epilepsy, Generalized / Q000178:diet therapy / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D019233:Retreatment; D012640:Seizures / Q000178:diet therapy / Q000503:physiopathology; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation
chemical_list: D000927:Anticonvulsants
keywords: Atkins; intractable; ketogenic; ketosis; retrial