Abstracts

Rationale: To describe the effect of Atkins modified diet (MD) in the management of medically intractable epilepsy in Danish children. Methods: MD is a liberalised form of Ketogenic diet (KD), where only carbohydrates are restricted (10 gram/ day); calories, fluids, fat and protein are free, however high fat is encouraged. MD was started at home following a 2-hour ambulant visit where parents were carefully instructed. Children had blood samples before start for ruling out carnitine-deficiency. 34 children (15 males, 19 females), median age 9.1 year (1.7-17.6), with medically intractable epilepsy (more than 1 seizure/ week, tried at least 3 antiepileptic drugs) started MD between June 2007- January 2009. They have been on MD 8.7 months in average (2- 22 months). 14 children (37%) had tried KD before. Results: The diet was well tolerated in all cases. None had increased cholesterol, triglycerides or lever enzymes at any control. After 3 months, 50% of patients (n= 17) had at least 50% seizure reduction; 26.5% (n= 9) had more than 90% seizure reduction and 14 % (n=5) were seizure-free. After 6 months 13 patients (38%) maintained at least 50% seizure-reduction. 26% (n=9) were on the diet for at least 12 months, all but 1 with at least 50% seizure-reduction. At the most recent status, 15 patients (44%) are still on the diet, 13 have at least 50% seizure reduction; of those 3 have > 90% reduction and 4 (11.7%) are seizure-free. Of the 14 patients (41%) who also tried KD, the effect of MD was similar to the KD in 13. Conclusions: Modified Atkins diet is a more feasible diet for most patients, with very few and transitory side-effects. Efficacy in this study has been comparable to KD (50% patients achieve >50% seizure-reduction).