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Evaluation of the Modified Atkins Diet for the Treatment of Epileptic Spasms Refractory to Hormonal Therapy: A Randomized Controlled Trial
Journal of Child Neurology ( IF 1.9 ) Pub Date : 2021-04-09 , DOI: 10.1177/08830738211004747
Suvasini Sharma 1 , Shaiphali Goel 1 , Dipti Kapoor 1 , Divyani Garg 2 , Isha Panda 1 , Aman Elwadhi 1 , Bijoy Patra 3 , Sharmila B Mukherjee 3 , Harish Pemde 3
Affiliation  

Objectives:

We aimed to evaluate the efficacy of the modified Atkins diet in children with epileptic spasms who had failed hormonal therapy.

Methods:

Children aged 9 months to 3 years having daily epileptic spasms despite a trial of ACTH or oral prednisolone and 1 additional anticonvulsant medication were enrolled. Children were randomly assigned to receive the modified Atkins diet either immediately or after a delay of 4 weeks. The ongoing anticonvulsant medications were continued unchanged. The primary outcome variable was the proportion of children who achieved spasm freedom as per parental reports at 4 weeks. Secondary outcomes included time to spasm cessation, proportion of children with electroclinical remission, the proportion of children with >50% reduction of spasms at 4 weeks, and adverse effects of the diet. (ClinicalTrials.gov Identifier: NCT03807141).

Results:

A total of 91 children were enrolled in the study; 46 in the diet group and 45 in the control group. At the end of 4 weeks, 11 children in the diet group were spasm free compared with none in the control group (P ≤ .001). The median time to achieve spasm cessation was 10 days (interquartile range 9-20). Nine of these had resolution of hypsarrhythmia on electroencephalography (EEG). Thirty (65.2%) in the diet group had >50% reduction in spasms, compared with none in the control group (P < .001). The most common side effect was constipation, noted in 34.8% of the children.

Conclusions:

The modified Atkins diet was found to be effective and well tolerated in children with epileptic spasms refractory to hormonal therapy.



中文翻译:

改良阿特金斯饮食治疗激素治疗难治性癫痫痉挛的评估:一项随机对照试验

目标:

我们旨在评估改良阿特金斯饮食对激素治疗失败的癫痫痉挛儿童的疗效。

方法:

尽管试验了 ACTH 或口服泼尼松龙和 1 种额外的抗惊厥药物,但仍患有每日癫痫痉挛的 9 个月至 3 岁的儿童被纳入研究。儿童被随机分配立即或延迟 4 周后接受改良的阿特金斯饮食。正在进行的抗惊厥药物继续保持不变。主要结果变量是根据父母报告在 4 周时实现无痉挛的儿童比例。次要结果包括痉挛停止的时间、电临床缓解的儿童比例、4周时痉挛减少> 50%的儿童比例以及饮食的不良影响。(ClinicalTrials.gov 标识符:NCT03807141)。

结果:

共有 91 名儿童参加了这项研究;饮食组46人,对照组45人。4 周结束时,饮食组 11 名儿童无痉挛,而对照组则无(P ≤ .001)。达到痉挛停止的中位时间为 10 天(四分位距 9-20)。其中九个在脑电图(EEG)上的高节律失常得到解决。饮食组中有 30 人 (65.2%) 的痉挛减少了 >50%,而对照组则没有 ( P < .001)。最常见的副作用是便秘,占 34.8% 的儿童。

结论:

改良的阿特金斯饮食被发现对激素治疗无效的癫痫痉挛儿童有效且耐受性良好。

更新日期:2021-04-09
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