Efficacy and tolerability of modified Atkins diet in Japanese children with medication-resistant epilepsy

Kumada, Takatsune; Miyajima, Tomoko; Oda, Nozomi; Shimomura, Hideki; Saito, Keiko; Fujii, Tatsuya

doi:10.1016/j.braindev.2010.12.010

Cited by 25 publications

(21 citation statements)

References 14 publications

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“…High calcium/creatinine ratios were seen in 40% but no child developed kidney stones and constipation was seen in 20%. Further small studies have confirmed efficacy and tolerability in children and teens 59,60 .…”

Section: A Modified Atkins Dietmentioning

confidence: 89%

What's New in the Medical Management of Pediatric Epilepsy?

Wirrell

2012

Can. J. Neurol. Sci.

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Epilepsy is one of the most common neurological conditions affecting the pediatric age group, with an estimated incidence of approximately 45 per 100,000 children per year 1,2 . Long-term, population-based follow-up studies in pediatric epilepsy have shown favorable outcomes in the majority of cases, with between two-thirds and three-quarters achieving seizurefreedom, and approximately half of children having remission of their epilepsy, meaning they are able to discontinue antiepileptic medication and remain seizure-free 3,4 . However, in approximately 20% children with new-onset epilepsy, seizures will become medically intractable.Epilepsy is not a single disorder, but rather describes a diverse group of seizure types, and an even more diverse group of etiologies. There is a minority of specific etiologies or electroclinical syndromes that have uniquely efficacious therapies. This paper will summarize the clinical manifestations, diagnostic work-up and therapy of some of these specific causes that are crucial to identify. Additionally, newer anti-epileptic medications (AEDs) and dietary options for pediatric epilepsy will be reviewed.Accurate classification of epilepsy is imperative to understand its natural history, pathophysiology and to decide on best therapy. A revised classification of epilepsy has recently been published 5 , and classifies seizure disorders based on mode of onset, etiology and electroclinical syndrome or constellation. Mode of onset is divided into generalized (bihemispheric), focal (unihemispheric) or unknown, and is important to identify as several medications exacerbate specific seizure types. Some of the sodium channel agents (carbamazepine, oxcarbazepine, phenytoin) and GABA-ergic medications (vigabatrin or ABSTRACT: Epilepsy affects approximately 45 per 100,000 children per year. While many cases respond favorably to antiepileptic therapy, approximately 20% will prove to be medically intractable. This paper reviews some of the recently identified important metabolic and autoimmune etiologies for which there are specific therapies. Additionally, newer antiepileptic medications, including rufinamide, lacosamide, retigabine, eslicarbazepine and brivaracetam and newer dietary options, including the modified Atkins diet and low-glycemic index diet are discussed.

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Section: A Modified Atkins Dietmentioning

confidence: 89%

What's New in the Medical Management of Pediatric Epilepsy?

Wirrell

2012

Can. J. Neurol. Sci.

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“…9,34,35 Effectiveness of the modified Atkins diet is comparable to the ketogenic diet in children 36,37 and adults. Decreased efficacy may be due to poorer compliance with strict calorie and carbohydrate limits and the added burden of weighing and measuring foods as part of daily living in adolescents and adults who are employed and who may themselves be care providers.…”

Section: Case 11-2mentioning

confidence: 99%

Dietary Treatment of Intractable Epilepsy

Cervenka¹,

Kossoff²

2013

CONTINUUM: Lifelong Learning in Neurology

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Dietary treatment options for epilepsy include the classic ketogenic diet, the medium-chain triglyceride diet, the modified Atkins diet, and the low glycemic index treatment. These were first used to control seizures in children with intractable epilepsy, but in recent years have also been demonstrated to be safe and effective in children and adults with a broad range of seizure types and are being used with increased frequency worldwide.

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“…The two types of KD protocol -the classical KD menu or the MAD regimen -were the therapies implemented in this study, as had been described in previous reports [1,27,28]. Two dietitians were responsible for all contacts with the families throughout the hospitalization.…”

Section: Kd Therapy Protocolmentioning

confidence: 99%

FMZ-PET to assess the efficacy and the mechanism of ketogenic diet in patients with intractable epilepsy

Nishii¹,

Hirai²,

Fujii³

et al. 2018

Imaging-Medicine

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FMZ-PET to assess the efficacy and the mechanism of ketogenic diet in patients with intractable epilepsy Methods: Six patients with intractable epilepsy (two females/four males; seizure-onset age: 0-30 months) were enrolled in this study. Medication-refractory seizures continued in all patients despite treatment with the anti-epilepsy drugs (AEDs), followed by two types of KD therapy; the classical KD menu or the MAD regimen. All patients underwent FMZ-PET before KD and at 1-5 months after induction of KD. Dynamic FMZ-PET scanning was acquired, followed by assessment of the BP images using the graphic plot method of Logan. Results: In KD-effective patients, the BPs of FMZ before KD were 1.31, 1.60 and 1.50 and those after induction of KD were 1.89, 2.13 and 2.07, respectively. In KD-partially effective patients, the BPs of FMZ before KD was 1.95 and 2.47 and those after induction of KD were 2.10 and 2.71, respectively. Conversely, in KD-ineffective case, the BP of FMZ was decreased from 3.91 before KD to 3.58. The BPchange ratios were 1.44, 1.33 and 1.38 in the KD-effective patients, 1.08 and 1.10 in the KD-partially effective patients, and 0.92 in the KD-ineffective one. Conclusion: The results of current study suggested that KD may control seizures by increasing BP of BZR and that FMZ-PET imaging would be useful to assess the efficacy of KD therapy in patients with intractable epilepsy.

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Efficacy and tolerability of modified Atkins diet in Japanese children with medication-resistant epilepsy

Cited by 25 publications

References 14 publications

What's New in the Medical Management of Pediatric Epilepsy?

What's New in the Medical Management of Pediatric Epilepsy?

Dietary Treatment of Intractable Epilepsy

FMZ-PET to assess the efficacy and the mechanism of ketogenic diet in patients with intractable epilepsy

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