A prospective study of the modified Atkins diet for adults with idiopathic generalized epilepsy

The role for ketogenic diets in epilepsy and status epilepticus in adults

“…In the largest observational study published to date of 101 adult patients (age ≥ 18 years) naïve to diet therapy who subsequently started the MAD, 39% had ≥50% seizure reduction and 22% became seizure free (Cervenka et al, 2016a). Thus, as summarized in Table 1, the classic KD reduces seizures by ≥50% in 22–70% of patients and ≥90% in up to 52% of patients and the MAD has a similar variability in published response rates, ranging from 12 to 67% with ≥50% seizure reduction and up to 67% of patients with ≥90% seizure reduction (Cervenka et al, 2016a, Johnson and Cervenka, 2017, Kverneland et al, 2015). …”

“…Thus, as summarized in Table 1, the classic KD reduces seizures by ≥50% in 22–70% of patients and ≥90% in up to 52% of patients and the MAD has a similar variability in published response rates, ranging from 12 to 67% with ≥50% seizure reduction and up to 67% of patients with ≥90% seizure reduction (Cervenka et al, 2016a, Johnson and Cervenka, 2017, Kverneland et al, 2015). …”

“…The number of adherers to diet therapy was reported in 11 of the studies with a combined compliance rate of 38% for the classic KD and 56% for the MAD (Ye et al, 2015). A more recent study of the classic KD noted 39% had a ≥50% seizure reduction (9 out of 23 patients ≥ 16 years of age) and 8% had a ≥90% seizure reduction (2 out of 23 adult patients) while a MAD study noted 31% had a ≥50% seizure reduction (4 out of 13 patients ≥ 16 years of age, using intention to treat analysis) (Kverneland et al, 2015, Schoeler et al, 2014). In the largest observational study published to date of 101 adult patients (age ≥ 18 years) naïve to diet therapy who subsequently started the MAD, 39% had ≥50% seizure reduction and 22% became seizure free (Cervenka et al, 2016a).…”

“…While there is a paucity of scientific evidence supporting efficacy of diet treatment as first-line therapy for these epilepsy syndromes given their relative rarity (Cervenka et al, 2017a, Rubenstein et al, 2005), there is evidence of particular effectiveness suggesting it may be appropriate to introduce the diet early (Barañano and Hartman, 2008, Bergin, 2017, Lee and Kossoff, 2011). In addition, high response rates and seizure freedom has been observed in adolescents and adults with juvenile myoclonic epilepsy with 2/3 of adults showing ≥50% seizure reduction and 1/6 adults seizure free in two separate small case series (Kossoff et al, 2013c, Kverneland et al, 2015). Similarly, a trend for increased benefit of diet therapy has been detected for patients with symptomatic generalized epilepsy compared to patients with focal epilepsies (Nei et al, 2014).…”

Diettbehandling av epilepsi

“…The diet may be effective in focal as well as generalised forms of epilepsy (7,9,11). It may have an anti-seizure effect for a number of paediatric epilepsy syndromes, such as West syndrome, Dravet syndrome, Rett syndrome, Lennox-Gastaut syndrome, tuberous sclerosis and syndromes associated with defects in the respiratory chain (7).…”