title: Efficacy and tolerability of the modified Atkins diet in young children with refractory epilepsy: Indian experience.
abstract: BACKGROUND
  The modified Atkins diet (MAD) has been used predominantly in older children, adolescents, and adults. There is a paucity of data on the use of the MAD in refractory epilepsy in young children.
  
  
  OBJECTIVE
  This study was planned to evaluate the efficacy and tolerability of the MAD in refractory epilepsy in young children.
  
  
  METHODS
  This study recruited children aged 9 months to 3 years with refractory seizures. Children received MAD for 6-month with the on-going anticonvulsant medications being continued unchanged. Reduction in seizure frequency was the primary outcome measure. Adverse effects were also studied.
  
  
  RESULTS
  Thirty-one children with daily seizures were studied with a median age of 18-month (range 9-30 months). West syndrome was the most common epilepsy syndrome (26, 86.6%). Twenty-one children remained on diet at 3 months and 13 at 6 months. The children who achieved >50% seizure reduction were 17 (54.8%) at 3 months and 9 (29%) at 6 months. Refusal to eat was a significant problem seen in eight children. Three children discontinued the diet due to adverse effects.
  
  
  CONCLUSIONS
  The MAD was found to be feasible, effective, and well-tolerated.
authors.affiliation: Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India.
authors.forename: Ranju
authors.initials: R
authors.lastname: Mehta
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India.
authors.forename: Shaiphali
authors.initials: S
authors.lastname: Goel
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India.
authors.forename: Suvasini
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Neonatal, Pediatric and Adolescent Medicine, Division of Pediatric Neurology, BL Kapur Super Speciality Hospital, New Delhi, India.
authors.forename: Puneet
authors.initials: P
authors.lastname: Jain
authors.affiliation: Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India.
authors.forename: Sharmila B
authors.initials: SB
authors.lastname: Mukherjee
authors.affiliation: Department of Pediatrics, Division of Pediatric Neurology, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India.
authors.forename: Satinder
authors.initials: S
authors.lastname: Aneja
keywords: Dietary therapy; West syndrome; infantile spasms