Efficacy and tolerability of the modified Atkins diet in young children with refractory epilepsy: Indian experience

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. OBJECTIVES: 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. CONCLUSION: The MAD was found to be feasible, effective, and well-tolerated.