Cardiovascular risk in adults with drug-resistant epilepsy submitted to the modified atkins diet

Abstract

Introduction: The modified Atkins diet (MAD) the carbohydrates are limited to 15–30 g/d and high fat intake is encouraged. It are used in children, being less studied in adults Objectives: To assess the impact of MAD over a 6-month period in adults with drug-resistant epilepsy in terms of reduction in seizure frequency and cardiovascular risk. Methods: Prospective and interventional study.Inclusion criteria:patients aged 18–60 yrs, with drug-resistant focal epilepsy, without surgical indication or in the postoperative of epilepsy surgery. Exclusion criteria were: use of corticosteroids, metabolic diseases, cholecystectomy or nephrolithiasis, inadequate nutrition, uncooperative parents or caregivers and inadequate sociofamily dynamics. All started the diet at a 1:1 ratio and ASMs. Study periods: baseline (P0), six month (P6). Carotid and vertebral Doppler ultrasounds were performed at P0 and P6 in order to assess possible alterations related to of the carotid arteries the intima-media thickness. Results: Twenty patients are being followed up, 12 of which started the MAD, and of these, 6 completed the six-month period of diet therapy and underwent pre and post-diet exams. The 6 patients showed no increase in mean total, low-density lipoprotein, triglycerides cholesterol levels.There was no change in the thickness of the myointimal complex of any patient, made by comparative analysis by ultrasonographic exam before and after six months of starting the diet. Four out of 6 patients had >50% reduction in seizures (two seizure free) and two had no change in frequency. Conclusion: MAD for six months in adults with drug-resistant focal epilepsy had a significant effect on the reduction of epileptic seizures and did not reveal alterations in the myointimal wall of the carotid arteries.