Research Institute of Endocrine Sciences, Shahid Beheshti Medical University, Shariati Avenue, Tehran, Iran.
Arch Iran Med. 2010 Nov;13(6):492-7.
The ketogenic diet is an effective medical therapy for intractable childhood epilepsy. However, it has drawbacks in that it restricts calories, fluids and protein. The Atkins diet may also induce ketosis without those restrictions. Our objective was to evaluate the efficacy of a modified Atkins diet in children with intractable childhood epilepsy.
This clinical trial was conducted in 51 epileptic children aged 1 - 16 years with refractory seizures from Feb. 2004 to Oct. 2006. Outcome measures included seizure frequency and adverse reactions. Twenty-seven patients left the study for various reasons, leaving 24 who continued the Atkins diet for a minimum of three months. Carbohydrates were initially limited to 10 g/day and fats constituted 60% of the total energy requirement. All participants received vitamin and calcium supplementation.
Following three months of treatment with the Atkins diet, 16 patients (67%) had >50% decrease in seizure frequency, and 6 (25%) had >90% improvement, of whom 5 were seizure-free. Mean seizure frequency after the first, second and third months of treatment were significantly lower than at baseline (P values <0.001, 0.001 and 0.002, respectively).
The Atkins diet can be considered as a safe and effective alternative therapy for intractable childhood epilepsy. Atkins diet was well tolerated in our patients with rare complications and it appears to demonstrate preliminary efficacy in childhood refractory epilepsy.
生酮饮食是治疗儿童难治性癫痫的有效医学疗法。但是，它有一些缺点，即限制热量、液体和蛋白质。阿特金斯饮食也可以在没有这些限制的情况下诱导酮症。我们的目的是评估改良阿特金斯饮食治疗儿童难治性癫痫的疗效。
本临床试验于 2004 年 2 月至 2006 年 10 月在 51 名年龄在 1-16 岁的难治性癫痫儿童中进行。疗效评估指标包括癫痫发作频率和不良反应。由于各种原因，27 名患者退出研究，留下 24 名继续接受阿特金斯饮食治疗至少 3 个月。最初将碳水化合物限制在 10 g/天，脂肪占总能量需求的 60%。所有参与者均接受维生素和钙补充。
接受阿特金斯饮食治疗 3 个月后，16 名患者（67%）癫痫发作频率下降>50%，6 名患者（25%）改善>90%，其中 5 名患者无癫痫发作。治疗后第 1、2 和 3 个月的平均癫痫发作频率明显低于基线（P 值分别为<0.001、0.001 和 0.002）。
阿特金斯饮食可被视为治疗儿童难治性癫痫的一种安全有效的替代疗法。我们的患者对阿特金斯饮食耐受性良好，并发症罕见，并且似乎在儿童难治性癫痫中显示出初步疗效。
