Abstracts

To determine seizure control provided by the use of the Low Glycemic Index treatment (LGIT), a diet modification. The LGIT limits total daily carbohydrates as well as carbohydrates that contain elevated glycemic index (elevation of postprandial blood glucose). A retrospective chart review was performed on patients initiating the LGIT at the Massachusetts General Hospital between January 2002 to December 2004. Patients initiating treatment after December 2004 were followed prospectively. Demographic and clinical information including seizure type and frequency by parental and self report, medications, and lab values were collected.
At diet initiation, education was provided to the patient/family regarding the restriction of high glycemic index carbohydrates, as well as limiting the total daily carbohydrates between 40-60 gms per day. Diets were further adjusted during treatment period based on seizure control and tolerability. Fifty patients were educated on using the LGIT as an alternative treatment modality to the classic ketogenic diet or medication changes. Patients ages ranged from 3 1/2 to 34 years, with a mean age of 10 years and a median age of 9 1/2 years. The population included 32 females and 18 males. Seizure types included partial onset 18 , generalized 20; 12 had mixed seizure disorders. Upon initiation of LGIT patients were concurrently on a range of 0-6 anticonvulsants with an average of 2. Patients were on an average of 5 prior therapies (range 1-10) before diet initiation. Total carbohydrate intake ranged from 20 - 100 gms/day.
The majority of patients experienced a significant reduction in seizure frequency; 15 had [gt]90% reduction. Two patients experienced a possible exacerbation of seizure frequency and discontinued the diet. Some patients/families found it difficult to comply with the limitations in carbohydrates, some families thought the diet should be more structured. The LGIT appears to be a effective treatment for childhood epilepsy. Work is ongoing to further develop the methodology in providing this treatment alternative. Additional prospective data is needed to delineat the role LGIT in childhood epilepsy.