Abstract
This chapter reviews the adjunctive ketogenic diet (KD) and modified Atkins diet (MAD) in the treatment of refractory epilepsy in adults. Only a few studies have been published, all open label. KD and MAD treatment shows modest efficacy, although in some patients the effect is remarkable. Side effects of both diets are benign and similar, and rarely lead to treatment discontinuation. The most serious side effect, hyperlipidemia, reverses readily with treatment discontinuation. Weight loss is common with both diets, and may be advantageous in patients with comorbid obesity. Potential barriers to large-scale use of both diets in adults include low rates of acceptance of the diet by patients and high rates of diet discontinuation. Overall, KD and MAD are welcome additions to the treatment armamentarium in adults with refractory epilepsy.
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