Modified ketogenic (Atkins) diet as a treatment option for adults with drug-resistant epilepsy

Abstract

Epilepsy is one of the most common neurological diseases affecting about 65 million people worldwide. The disease is characterized by recurrent epileptic seizures either of unknown cause or caused by diverse pathologies such as congenital malformations of the brain, head trauma, brain tumor or stroke. Although there are almost 30 antiepileptic drugs on the Norwegian market, only about 2/3 of the patients achieve seizure control by using these drugs. For the remaining patients (12000 in Norway) there is an urgent need of other treatment options. Since ancient times it has been known that fasting may reduce seizure susceptibility in epilepsy. To mimic fasting, a diet low in carbohydrate and high in fat, the ketogenic diet, can be used. In the thesis Modified ketogenic (Atkins) diet as a treatment option for adults with drug-resistant epilepsy, clinical dietitian Magnhild Kverneland and co-workers have investigated whether this ketogenic diet variant, given as a supplement to drugs, may reduce seizure frequency and severity in adults with drug-resistant epilepsy. A total of 75 patients were randomized to either diet group implying 12 weeks on diet, or to a control group. There were considerable inter-individual variations in response to the treatment: A few patients had excellent effect, more patients had a moderate effect, while some had no effect at all. Unexpectedly, the diet seemed to cause a fall in the serum concentrations of some of the antiepileptic drugs. This may negatively have influenced the effect of the dietary intervention. The study is a pioneer work within the field. New insights were gained on dietary treatment in adults with difficult-to-treat epilepsy, and as a direct consequence of the study, dietary treatment is now being established as a therapy option to adults with drug-resistant epilepsy in Norway.