A Pilot Study of The Modified Atkins Diet For Sturge–Weber Syndrome

The modified Atkins diet (MAD) is a dietary treatment for epilepsy which does not restrict fluids or calories. This theoretically makes the MAD safer than the ketogenic diet for children with Sturge–Weber syndrome (SWS). Five children aged 4–18 years with SWS and at least monthly intractable seizures were started prospectively on the MAD for 6 months. All children had urinary ketosis and seizure improvement, including 3 with >50% seizure reduction.

Various Indications For a Modified Atkins Diet in Intractable Childhood Epilepsy

A long-term treatment with the MAD was well tolerated. Moreover, the MAD can successfully substitute the classic KD in patients who showed improvement in seizure outcomes by the KD. 9 patients maintained the MAD with favorable seizure outcomes (a reduction of seizure frequency by over 50%) or successfully completed the diet therapy.

Efficacy of the Atkins Diet as Therapy For Intractable Epilepsy

Six patients were started on the Atkins diet for the treatment of intractable focal and multifocal epilepsy. Five patients maintained moderate to large ketosis for periods of 6 weeks to 24 months; three patients had seizure reduction and were able to reduce antiepileptic medications. This provides preliminary evidence that the Atkins diet may have a role as therapy for patients with medically resistant epilepsy.

When Do Seizures Usually Improve With The Ketogenic Diet?

The KD works quickly when effective, typically within the first 1–2 weeks. Starting the KD after a fasting periodmay lead to a more rapid, but equivalent long-term seizure reduction, confirming prior reports. If the KD has not led to seizure reduction after 2 months, it can probably be discontinued.

Dietary Therapies for Epilepsy

The two major nonpharmacologic treatments for patients with epilepsy are neurostimulation devices (e.g. vagus nerve stimulators) and dietary treatments (ketogenic). In this review, we will cover the latter treatments, namely, using diets.