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Efficacy of the classic ketogenic and the modified Atkins diets in refractory childhood epilepsy

Authors
 Jeong A Kim  ;  Jung-Rim Yoon  ;  Eun Joo Lee  ;  Joon Soo Lee  ;  Jeong Tae Kim  ;  Heung Dong Kim  ;  Hoon-Chul Kang 
Citation
 Epilepsia, Vol.57(1) : 51-58, 2016 
Journal Title
 Epilepsia 
ISSN
 0013-9580 
Issue Date
2016
MeSH
Adolescent ; Child ; Child, Preschool ; Diet, Carbohydrate-Restricted/methods* ; Diet, Ketogenic/methods* ; Double-Blind Method ; Drug Resistant Epilepsy/blood ; Drug Resistant Epilepsy/diet therapy* ; Female ; Follow-Up Studies ; Humans ; Infant ; Ketone Bodies/blood ; Male ; Treatment Outcome
Abstract
OBJECTIVE: We aimed to compare the efficacy, safety, and tolerability of a modified Atkins diet (MAD) with the classic ketogenic diet (KD) for the treatment of intractable childhood epilepsy. METHODS: From March 2011 to March 2014, 104 patients aged 1-18 years who had refractory epilepsy were randomly assigned to each diet group (ClinicalTrials.gov, number NCT2100501). A seizure diary record was used to compare seizure frequencies with the baseline prediet seizure frequency at the third and sixth months after diet therapy initiation. RESULTS: Fifty-one patients were assigned to the KD and 53 patients to the MAD. The KD group had a lower mean percentage of baseline seizures compared with the MAD group at 3 months (38.6% for KD, 47.9% for MAD) and 6 months (33.8% for KD, 44.6% for MAD), but the differences were not statistically significant (95% confidence interval [CI] 24.1-50.8, p = 0.291 for 3 months; 95% CI 17.8-46.1, p = 0.255 for 6 months). Instead, for patients aged 1-2 years, seizure outcomes were consistently much more favorable in patients consuming the KD compared with those consuming the MAD. The rate of seizure freedom at 3 months after diet therapy initiation was significantly higher (53% for KD, 20% for MAD, p = 0.047) in these patients. The MAD had advantages with respect to better tolerability and fewer serious side effects. SIGNIFICANCE: The MAD might be considered as the primary choice for the treatment of intractable epilepsy in children, but the classic KD is more suitable as the first line of diet therapy in patients <2 years of age.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/epi.13256/abstract
DOI
10.1111/epi.13256
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
강훈철(Kang, Hoon Chul) ORCID logo https://orcid.org/0000-0002-3659-8847
김정아(Kim, Jeong A)
김흥동(Kim, Heung Dong) ORCID logo https://orcid.org/0000-0002-8031-7336
윤정림(Yoon, Jung Rim)
이준수(Lee, Joon Soo) ORCID logo https://orcid.org/0000-0001-9036-9343
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146251
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