Low glycemic index treatment in patients with drug-resistant epilepsy

Abstract

OBJECTIVE: Low glycemic index treatment (LGIT) is a newly developed dietary therapeutic option for epilepsy that is less restrictive than the ketogenic diet (KD). Our objective was to determine the efficacy and tolerability of LGIT.

METHODS: From March 2014 to February 2015, 36 patients received LGIT at Severance Children's Hospital. One-year seizure outcomes and side effects were evaluated.

RESULTS: A total of 36 patients were assessed. Fourteen were female. Common diagnoses were Lennox-Gastaut syndrome (33%, 12/36) and Dravet syndrome (14%, 5/36). The median age at the initiation of the LGIT was 12.6years (min.=1.5, max.=28, interquartile range (IQR) 8-17). After 3months of therapy, 20 (56%) patients experienced a 50% or greater reduction in seizure frequency, which was maintained in 19 (53%) patients for 1year. Two (6%) patients became seizure-free after 3months of LGIT; they remained seizure-free for 1year. These two had Dravet syndrome and generalized epilepsy. Only three (8%) patients discontinued treatment within 1year. Adverse events were rare, and two patients (6%) reported transient diarrhea.

CONCLUSIONS: LGIT effectively reduced seizure frequency in the present study, although seizure freedom was infrequently achieved. LGIT may be considered as a therapeutic option for patients with drug-resistant epilepsy, particularly those who find KD effective but intolerable.