Ketogenic, Modified Atkin’s diets effective for genetic refractory epilepsy in children
The ketogenic (KD) and Modified Atkin’s diets (MAD) are effective treatments for children with refractory epilepsy of genetic aetiology, a new study suggests.
Researchers reviewed the records of 59 children (median age at diet onset 2.2 years; 63 percent female) with refractory epilepsy of genetic aetiology. Majority (90 percent; n=53) of the children received a traditional KD while the remaining 10 percent (n=6) received MAD. Diet response was assessed at 1, 3, 6, 12 and 24 months.
Of the enrolled children, three terminated the intervention within a week of initiation due to difficulty in preparing meals, severe ketoacidosis and severe reflux. At the end of the first and third months, 17 children remained on the diet, resulting in a responder rate of 72 percent.
At 6, 12 and 24 months, there were 12, 10 and five children still on the diet, respectively, resulting in corresponding responder rates of 56 percent, 44 percent and 28 percent.
The efficacy of the diet intervention did not seem to differ according to genetic mutations. In children with mutation in the SCN1A gene, responder rate after 24 months was 45 percent. In comparison, corresponding rates were 50 percent and 55 percent in those with CDKL5 and SLC2A1 mutations.
In terms of safety, seven participants (12 percent) terminated the dietary intervention due to adverse events, such as severe gastroesophageal reflux, severe ketoacidosis, weight loss, food refusal, weight gain and persistent elevation of triglycerides.