Abstract
Compared to the classical ketogenic diet (KD), the modified Atkins diet (MAD) and the low glycemic index treatment (LGIT) are more liberal and less restrictive diet therapies for the treatment of medication-resistant epilepsy. The MAD was first reported by Kossoff et al. in 2003, and gained global popularity with sufficient evidence in its efficacy reported recently in a controlled study. The LGIT was first reported by Pfeifer et al. in 2005, and its use has also become widespread. We reviewed the efficacy of both diet therapies in the treatment of medication-resistant epilepsy based on the evidence from previous literatures and our own clinical experience. From our experience, the LGIT was more liberal, tolerable, and dietetically balanced than the MAD. To find out which of these diets is most appropriate in different epilepsies and different patients, future controlled comparative studies on the efficacy, tolerability, and dietetic advantages between the MAD and the LGIT are necessary.
Highlights
The ketogenic diets (KDs) have been used for the treatment of medication-resistant epilepsy since the 1920s
The classical KD result in at least a 50% reduction in seizure frequency in approximately half of epileptic patients, some patients cannot tolerate the diet over a long period of time because of its restrictiveness
Because the KDs including modified Atkins diet (MAD) and low glycemic index treatment (LGIT) are the therapy that the patients and parents must prepare by themselves, the menus of the KDs are greatly affected by their food culture
Summary
The ketogenic diets (KDs) have been used for the treatment of medication-resistant epilepsy since the 1920s. The modified Atkins diet (MAD) and the low glycemic index treatment (LGIT) that are more liberal and less restrictive than the classical KD, were developed in the 1990-2000s [1,2].
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