For children with pharmacoresistant
epilepsy, the
ketogenic diet is an established treatment option worldwide. However, for adults, this treatment is less frequently offered, and its efficacy less well-documented. The aim of this study was to examine efficacy and tolerability of such a diet as an adjuvant
therapy to
antiepileptic drugs for adult patients with pharmacoresistant
generalized epilepsy. Thirteen patients (12 women) aged 16-57 years were included prospectively. They were treated with a modified
Atkins diet for 12 weeks. Nine of the 13 participants had
juvenile myoclonic epilepsy (JME), two had
childhood absence epilepsy, one had Jeavons syndrome, and one had
generalized epilepsy of unknown type. Six participants, all with JME, completed the 12-week study period. Among these six, four had >50% seizure reduction. Their seizure severity, using the revised Liverpool Seizure Severity Scale, was reduced by 1, 5, 57.5, and 70 points, respectively (scale: 1-100 points). In three of these four responders, quality of life, assessed by QOLIE-89, increased more than 20 points (scale: 0-100 points). Mean reduction of
body weight after 12 weeks on diet was 6.5 (range: 4.3-8.1) kg. Lack of motivation, poor compliance, and seizure aggravation were the main reasons for premature termination of the diet. Apart from one patient who developed
gallstones when ending the treatment after 10 months, no adverse effects were noted. In conclusion, using a modified
Atkins diet for 12 weeks led to a clinically relevant reduction of seizure frequency in four of thirteen adult patients with pharmacoresistant
generalized epilepsy. All responders were diagnosed with JME. In three of the four, the benefits of diet were so considerable that they chose to continue the treatment.