A pilot trial with modified Atkins’ diet in adult patients with refractory epilepsy

Objectives At Ghent University Hospital, the feasibility and efficacy of the modified Atkins’ diet was evaluated in adult patients with refractory epilepsy. The Atkins’ diet restricts carbohydrate intake and was originally designed for weight loss. Patients and methods During a 6-month trial period, a carbohydrate restriction of 20 g/day was in place. During a 36 h hospital admission, patients were instructed about the diet. Patients underwent clinical neurological testing, EEG, ECG, blood and urine analyses and mood evaluation before and during the trial. Seizure frequency and side effects were recorded in seizure diaries and followed up at monthly clinic visits. Results Eight patients were included in the study. Three out of eight patients followed the diet for 6 months. One out of three patients showed a >50% seizure reduction, 1/3 > 30%, and 1/3 < 30%. Side effects such as constipation and diarrhoea were mild and occurred mainly during the initial week of the diet. Patients reported improved concentration and well being. This was confirmed by improved scores on the Beck Depression Inventory Scale. Conclusion This pilot study shows that the modified Atkins’ diet is feasible in an adult population, and that seizure frequency reduction is possible. The results need to be confirmed in larger prospective, controlled studies with comparison groups.