Department of Paediatrics, Danish Epilepsy Centre, Filadelfia, Dianalund, Denmark.
Seizure. 2011 Mar;20(2):151-5. doi: 10.1016/j.seizure.2010.11.010. Epub 2010 Dec 3.
Modified Atkins diet (MAD) is a less restrictive variety of the classical ketogenic diet (KD), used for treating patients with medically resistant epilepsy. There are only few reports comparing the two types of diets in terms of seizure reduction and tolerability. We compared the effect of a MAD evaluated prospectively on 33 consecutive children with medically resistant epilepsy, with a group of 50 patients, previously treated with KD. Patients who had >50% seizure reduction were considered responders. After 3 months on the MAD, 17 patients (52%) were responders, including 14 (42%) who had >90% seizure reduction. After 6 months, 13 patients (39%) were responders. Seventeen patients (52%) remained on the MAD at least 12 months with excellent overall tolerance and compliance, including 9 patients (27%) who were responders, 4 of them (12%) having >90% seizure reduction. Although there was a trend for higher incidence of responders in the KD group, this failed to reach the level of significance: after 6 months 39% on MAD and 60% on KD were responders. However, this trend was not observed when the two groups were adjusted for difference in age (patients in the MAD group were older than the KD group). In conclusion, our experience suggests that the MAD is similarly effective as the KD in reducing seizure frequency in children with medically resistant epilepsy.
改良阿特金斯饮食（MAD）是经典生酮饮食（KD）的一种限制较少的变体，用于治疗药物难治性癫痫患者。只有少数报告比较了这两种饮食在减少癫痫发作和耐受性方面的效果。我们比较了前瞻性评估的 MAD 在 33 例药物难治性癫痫连续患者中的效果，与之前用 KD 治疗的 50 例患者进行比较。癫痫发作减少>50%的患者被认为是有反应者。在 MAD 治疗 3 个月后，17 名患者（52%）有反应，其中 14 名（42%）癫痫发作减少>90%。治疗 6 个月后，13 名患者（39%）有反应。17 名患者（52%）至少在 12 个月内继续接受 MAD 治疗，整体耐受性和依从性良好，其中 9 名患者（27%）有反应，其中 4 名（12%）癫痫发作减少>90%。尽管 MAD 组有更高比例的有反应者的趋势，但这并未达到显著水平：在 MAD 组中，有 39%在 6 个月时有反应，在 KD 组中，有 60%有反应。然而，当两组按年龄差异进行调整时，这种趋势并不明显（MAD 组的患者比 KD 组的患者年龄更大）。总之，我们的经验表明，MAD 在减少药物难治性癫痫儿童的癫痫发作频率方面与 KD 同样有效。
