Abstracts

The purpose of this study is to determine if dietary intervention can be an effective and sustainable method of seizure reduction when used in addition to standard drug therapy. The ketogenic diet (KD)has been used in children with varying degrees of success; however, the diet has been very difficult for adults to follow due its unpalatable nature. The Atkins Diet (AD) which like the (KD), achieves a state of ketosis may be an alternative., Patients with pharmacoresistant epilepsy were randomized into one of two treatment groups- either basic or intensive dietary counselling and initiated with a 20 gram carbohydrate diet. Menu plans and AD guidelines were provided. A control group was aged-matched to groups 1 and 2 and consisted of patients who were unable to follow the AD. Patients were assessed by dietitian, physician, psychologist and nurse. Cholesterol, triglicerides and fasting blood sugar were measured at baseline and at 6 months. Food intake records, ketosis, weight and Body Mass Index (BMI) were evaluated. Various aspects of seizure quality were collected, including seizure frequency, severity and recovery time. In addition, we measured cognitive status and health-related quality oif life (QOLIE-31)., Seven patients in the treatment groups have completed 6 months on the AD. All patients completed food records that showed 90% compliance with diet and acceptable caloric intake . All patients who had BMI over 30 achieved a healthier BMI of under 30. Cholesterol and trigliceride levels remained in acceptable ranges. All patients achieved ketosis. More than half reported a reduction in seizure intensity as well as a shorter recovery time after a seizure. There was a moderate improvement in attention and learning efficiency, both below average at baseline and at the six month follow-up, but no change in quality of life ratings., The AD can achieve sustainable ketosis over time. The great majority of patients showed acceptable compliance. Fifty percent of the cohort studied showed worthwhile improvement in their seizure disorder. Although results are preliminary given the small sample completing the protocol at this point, they suggest the AD may be a useful adjunct in the treatment of refractory epilepsy.,