Jeong A Kim,, Jung-Rim Yoon, Eun Joo Lee, Joon Soo Lee, Jeong Tae Kim, Heung Dong Kim, Hoon-Chul Kang. Efficacy of the classic ketogenic and the modified Atkins diets in refractory childhood epilepsy. Epilepsia. Article first published online: 10 DEC 2015
Summary
Objective
We aimed to compare the efficacy, safety, and tolerability of a modified Atkins diet (MAD) with the classic ketogenic diet (KD) for the treatment of intractable childhood epilepsy.
Methods
From March 2011 to March 2014, 104 patients aged 1–18 years who had refractory epilepsy were randomly assigned to each diet group (ClinicalTrials.gov, number NCT2100501). A seizure diary record was used to compare seizure frequencies with the baseline prediet seizure frequency at the third and sixth months after diet therapy initiation.
Results
Fifty-one patients were assigned to the KD and 53 patients to the MAD. The KD group had a lower mean percentage of baseline seizures compared with the MAD group at 3 months (38.6% for KD, 47.9% for MAD) and 6 months (33.8% for KD, 44.6% for MAD), but the differences were not statistically significant (95% confidence interval [CI] 24.1–50.8, p = 0.291 for 3 months; 95% CI 17.8–46.1, p = 0.255 for 6 months). Instead, for patients aged 1–2 years, seizure outcomes were consistently much more favorable in patients consuming the KD compared with those consuming the MAD. The rate of seizure freedom at 3 months after diet therapy initiation was significantly higher (53% for KD, 20% for MAD, p = 0.047) in these patients. The MAD had advantages with respect to better tolerability and fewer serious side effects.
Significance
The MAD might be considered as the primary choice for the treatment of intractable epilepsy in children, but the classic KD is more suitable as the first line of diet therapy in patients <2 years of age.
Courtesy of: http://www.mdlinx.com/neurology/medical-news-article/2015/12/11/epilepsy-childhood-atkins-diets/6450166/?category=sub-specialty&page_id=1&subspec_id=317
Courtesy of: http://www.mdlinx.com/neurology/medical-news-article/2015/12/11/epilepsy-childhood-atkins-diets/6450166/?category=sub-specialty&page_id=1&subspec_id=317
Rahmi Özdemir, Orkide Güzel, Mehmet Küçük, Cem Karadeniz, Nagehan Katipoglu,Ünsal Yılmaz, Murat Muhtar Yılmazer, Timur Meşe. The Effect of the Ketogenic Diet on the Vascular Structure and Functions in Children with Intractable Epilepsy. Pediatric Neurology. Published Online: November 26, 2015
ReplyDeleteAbstract
Objective
In this study, we aimed to determine the mid-term effect of ketogenic diet (KD) on serum lipid levels, carotid intima media thickness, and the elastic properties of the carotid artery and the aorta in patients with intractable epilepsy.
Methods
A total of 52 children aged between 12 months and 18 years with intractable epilepsy who started ketogenic diet at the pediatric neurology clinic from September 2014 to September 2015 were included into this prospective study. Carotid intima media thickness, and the elastic properties of the carotid artery and the aorta were assessed by means of echocardiography in all cases prior to beginning of KD and after at least 12 months on KD.
Results
Twenty-one patients at the third month and 25 patients at the first year of the KD were seizure free. A reduction of >90% in the seizure frequency was achieved in 3 patients at the sixth month and 5 patients at the first year of the treatment. The serum levels of total cholesterol, low-density lipoprotein, and triglyceride were increased significantly at a median of 12.6 months (range: 12–13.5 months) of KD treatment, while serum levels of HDL did not change. Carotid intima media thickness, aortic and carotid strain, the stiffness index, distensibility, and elastic modulus did not change after 12 months of KD therapy
Conclusion
Olive-oil based ketogenic diet appears to have no disturbing effect on carotid intima media thickness, the elastic properties of the aorta and the carotid artery in epileptic children, although it may be associated with increased concentrations of serum lipids.
Courtesy of: http://www.mdlinx.com/neurology/medical-news-article/2015/12/10/epilepsy-ketogenic-diet-children-vascular-function/6436191/?category=sub-specialty&page_id=1&subspec_id=317