Modified Atkins Diet for the Treatment of Refractory Epilepsy in Children: A Pilot Study from Indonesia

Objective: To know the efficacy of the modified Atkins diet (mAD) among children with refractory epilepsy. Method: Pre and post treatment interventional study with children diagnosed as refractory epilepsy aged 2-18 years old from April 2021-March 2022 at Dr.Cipto Mangunkusumo Tertiary General Hospital Jakarta, Indonesia. The subjects were given mAD ketogenic diet based on Indonesian Menu (as an add-on to the ongoing antiseizure drugs) who met the inclusion criteria. Main outcome measures is proportion of children who achieved seizure reduction as defined by minimal 25% cessation of seizure at 4, 12, and 24 weeks Results: Of the 41 recruited children, 28 succeed followed mAD, 13 were drop out and lost to follow up. The proportion of children with seizure reduction in first 4 weeks was 53%, 12 weeks 32%, and 24 weeks 15% (p 0,028). The proportion of children with ≥25% seizure reduction was significantly higher at first 4 and 12 weeks. The diet was well tolerated with nausea and vomiting being the most common adverse effects in children. Conclusions: The modified Atkins diet may be effective and well tolerated in Indonesian children with refractory epilepsy.