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

Ten Japanese patients aged 1.5–17 years with medication-resistant epilepsy were placed on the modified Atkins diet (MAD) for 3 weeks during admission to our hospital. Dietary carbohydrate was restricted to 10 g per day. We studied the efficacy of the diet regarding the seizure frequency and tolerability of the diet at the end of the 3 weeks on the diet. Those who decided to continue the MAD at the time of discharge were followed up in the out-patient clinic to observe the effect of the diet on the seizure frequency. Three of the 10 patients could not continue the diet during the 3-week admission; one had rotavirus enterocolitis and the other 2 disliked the diet. Among the remaining 7 patients who could continue the diet for 3 weeks, 3 achieved the seizure reduction; 2 became seizure-free and 1 showed about 75% reduction in the seizure frequency within 10 days on the diet. All of these 3 patients continued the diet after the 3-week admission. The other 4 patients did not show a reduction of the seizure frequency by the end of the 3 weeks on the diet. Two of them discontinued the diet on discharge. The remaining 2 still continued the diet at home and one became seizure-free 3 months after the start of the diet. In total, 4 of 10 patients achieved >75% reduction in the seizure frequency, although relapse occurred in 2 of the patients, at 5 months and 2 years after seizure reduction, respectively. The MAD was effective and well-tolerated in children with medication-resistant epilepsy in Japan.