Weber Susanne, Mølgaard Christian, Uldall Peter
Clinic of Child Neurology, Rigshospitalet, 2100 Copenhagen, Denmark.
Seizure. 2009 May;18(4):237-40. doi: 10.1016/j.seizure.2008.10.004. Epub 2008 Dec 3.
The aim of the present study was to evaluate the tolerability and efficacy of the modified Atkins diet given to children and adolescents with antiepileptic drug (AED) treatment resistant epilepsy. 15 children with medically intractable epilepsy were enrolled in the study. Inclusion criteria were at least one seizure a week and a trial of at least two AEDs without obtaining seizure freedom documented in a seizure calendar. At baseline subjects initiated a diet with carbohydrates restricted to make up 10 energy percent. If seizures were reduced by less than 50% after 7-14 days carbohydrates were further restricted to 10g per day. No change in AED treatment was allowed. The diet was well tolerated. After 3 months six out of the fifteen children (40%) had a seizure reduction of more than 50%, which was seen in different epileptic syndromes and different age groups. The responders reported an increase in quality of life and cognition. At 12 months follow-up 3 (20%) continued the diet with an unchanged marked seizure reduction. The present study confirms the high tolerability and effect of the modified Atkins diet on seizure control in AED treatment resistant epilepsy. Further larger prospective studies are however needed to confirm these results.
本研究的目的是评估改良阿特金斯饮食疗法用于治疗对抗癫痫药物（AED）耐药的儿童和青少年癫痫患者时的耐受性和疗效。15名患有药物难治性癫痫的儿童参与了该研究。纳入标准为每周至少发作一次癫痫，且至少试用过两种AED，但癫痫发作日历中未记录达到无癫痫发作状态。在基线时，受试者开始食用碳水化合物含量限制在占能量10%的饮食。如果7 - 14天后癫痫发作减少不到50%，则将碳水化合物进一步限制至每天10克。AED治疗不允许改变。该饮食耐受性良好。3个月后，15名儿童中有6名（40%）癫痫发作减少超过50%，不同癫痫综合征和不同年龄组均有此情况出现。有反应者报告生活质量和认知能力有所提高。在12个月的随访中，3名（20%）继续采用该饮食疗法，癫痫发作显著减少且情况未变。本研究证实了改良阿特金斯饮食疗法在治疗对AED耐药的癫痫时具有高耐受性和控制癫痫发作的效果。然而，需要进一步开展更大规模的前瞻性研究来证实这些结果。
