Introduction: 

At Ghent University Hospital, a pilot study on the feasibility and efficacy with Atkins' diet, a ketogenic-like diet, has been set up to evaluate its potential as a valuable treatment to control seizures in patients with refractory epilepsy.

Methods: 

At the start of the study, the epilepsy patients database was screened for patients with at least 2 seizures a month and without metabolic disorders. The protocol started with the admittance of patients the neurology department for 48 hours during which the diet is explained and practicalities of the studies were taught such as daily checking of urine ketosis and blood level glucose. Also patients underwent 24 hour EEG monitoring, evoked potential examinations, ECG and metabolic check up using blood samples as baseline investigations. Patients are contacted every 2 weeks by phone to check for side effects and seizure control. Patients are followed-up at the epilepsy clinic monthly for clinical evaluation, EEG and ECG and metabolic check-up. After 6 months patients will be readmitted to the neurology department to reperform the same investigations as during the baseline admittance.

Results: 

23 patients with refractory seizures, who are followed at the Reference Centre for refractory epilepsy, were screened. 14/23 patients fulfilled the inclusion criteria. Out of 14 patients who were contacted, 8 agreed to follow the diet during the initial trail of 6 months after receiving information on the diet. 7/8 started the diet as explained at home, 1/8 never initiated the diet at home. Up till now 1/7 stopped the diet after 50 days because the patient had to stop smoking too and the partner wasn't supportive anymore. 6/7 are still following the diet and have a mean follow-up of 32 days (11–53). Side effects (diarrhoea, constipation, muscle cramps in the legs and headache) are tolerable, seem transient and occur mainly at the onset of the diet.

Conclusion: 

Initial results in the first patients included in this pilot trail on the feasibility of introducing Atkins' diet as a treatment for epilepsy, seem promising. Further results on the efficacy of the diet and long term patient compliance will be available in the coming months.