Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Epilepsia. 2013 Mar;54(3):481-6. doi: 10.1111/epi.12069. Epub 2013 Jan 7.
The aim of this study was to evaluate the efficacy of the modified Atkins diet in a randomized controlled trial in children with refractory epilepsy.
Children aged 2-14 years who had daily seizures despite the appropriate use of at least three anticonvulsant drugs were enrolled. Children were randomized to receive either the modified Atkins diet or no dietary intervention for a period of 3 months. The ongoing anticonvulsant medications were continued unchanged in both the groups. Seizure control at 3 months was the primary end point. Analysis was intention to treat. Adverse effects of the diet were assessed by parental reports (ClinicalTrials.gov Identifier: NCT00836836).
Among a total of 102 children, 50 were in the diet group and 52 in the control group. Four children discontinued the diet before the study end point, and three children in the control group were lost to follow-up. The mean seizure frequency at 3 months, expressed as a percentage of the baseline, was significantly less in the diet group: 59 ± 54 (95% confidence interval [CI] 44-74.5) versus 95.5 ± 48 (95% CI 82-109), p = 0.003. The proportion of children with >90% seizure reduction (30% vs. 7.7%, p = 0.005) and >50% seizure reduction was significantly higher in the diet group (52% vs. 11.5%, p < 0.001). Constipation was the most common adverse effect among children on the diet (23, 46%).
The modified Atkins diet was found to be effective and well tolerated in children with drug-refractory epilepsy.
本研究旨在评估改良阿特金斯饮食在随机对照试验中对耐药性癫痫儿童的疗效。
纳入每天发作且至少使用三种抗癫痫药物治疗但仍未控制的 2-14 岁儿童。将儿童随机分为改良阿特金斯饮食组或不进行饮食干预组，为期 3 个月。两组均继续使用相同的抗癫痫药物。3 个月时的癫痫控制情况为主要终点。分析采用意向治疗。通过家长报告评估饮食的不良反应（ClinicalTrials.gov 标识符：NCT00836836）。
共有 102 名儿童参与研究，其中 50 名儿童在饮食组，52 名儿童在对照组。4 名儿童在研究终点前停止了饮食，3 名对照组儿童失访。饮食组 3 个月时的平均癫痫发作频率（以基线的百分比表示）明显低于对照组：59±54（95%置信区间[CI]：44-74.5）比 95.5±48（95%CI：82-109），p=0.003。饮食组癫痫发作减少>90%（30%比 7.7%，p=0.005）和减少>50%的儿童比例明显高于对照组（52%比 11.5%，p<0.001）。饮食组最常见的不良反应是便秘（23 例，46%）。
改良阿特金斯饮食对耐药性癫痫儿童有效且耐受良好。
