Abstracts

Rationale: There is a growing interest in dietary treatment of epilepsy. While the benefit of dietary treatment in children with medically intractable epilepsy has been established, limited data is available among the adult population. The aim of this retrospective study was to evaluate the efficacy and tolerability of Modified Atkins Diet (MAD) and Low Glycemic Index Diet (LGID) among adults with medically intractable epilepsy as an add-on treatment modality. Methods: Medical records of 34 adults with medically intractable epilepsy treated with MAD or LGID were retrospectively reviewed. All patients were seen and treated at the Dietary Treatments of Epilepsy Clinic at the Rush Epilepsy Center by an epileptologist and registered dietitian. After an education session, either the MAD or LGID was initiated, based on clinician recommendation and patient preference. Treatment outcomes included self-reported: 1) improvement of seizure control, defined as >50% improvement in seizure frequency from pre-diet, 2) improvement of quality of life, reported as subjective improvement in mood and/or alertness, and 3) side effects, including weight loss, defined as >5% loss from pre-diet, constipation, and elevated total cholesterol (TC), defined as TC >200 mg/dL. Outcomes were assessed after three months of MAD or LGID treatment. Results: A total of 34 patients with medically intractable epilepsy were reviewed, of which 27 patients (79%) were females; Table 1. Age ranged from 18 to 70 years (mean 38 years). A total of 27 patients followed MAD (79%), while 7 patients followed LGID (21%). A total of 15 patients (44%) reported >50% improvement in seizure frequency. Of those reporting >50% seizure frequency, 12 patients (80%) were on MAD, and 3 patients (20%) were on LGID. Among all 34 patients, quality of life was improved in 27 patients (79%). The most common side effects included weight loss in 19 patients (56%), and constipation in 6 patients (18%). Only minimal changes in TC were noted; of the 20 patients with TC values available at follow up, 7 patients (35%) had TC >200 mg/dL; however, only 2 patients (10%) with normal pre-diet TC had TC >200 mg/dL at follow up. Conclusions: This retrospective study suggests that both MAD and LGID are well tolerated and may be effective in improving seizure control and quality of life of among adults with medically intractable epilepsy with minimal side effects. Future prospective controlled studies are necessary to further evaluate the benefit of these dietary treatments.