Efficacy of dietary therapy for juvenile myoclonic epilepsy

Juvenile myoclonic epilepsy (JME) is often successfully managed with anticonvulsants; however, some patients may have medically resistant seizures. The modified Atkins diet (MAD) has been reported as effective for idiopathic generalized epilepsy and is increasingly being used in adolescents and adults. Since 2006, 8 adolescents and adults have been started on the MAD for JME at Johns Hopkins Hospital. Of these 8 patients, 6 (75%) were female, with a mean age at seizure onset of 10.5 years (range: 6–13 years) and 24.3 years (range: 15–44 years) at MAD initiation. After 1 month, 6 (75%) patients had > 50% seizure reduction, and after 3 months, 5 (63%) patients had > 50% improvement. Several patients found the MAD difficult to adhere to, including 3 patients who reported temporarily increased seizures during periods of noncompliance. In this limited experience, the modified Atkins diet was an efficacious adjunctive therapy for young adults with very medically resistant JME. ⺠The modified Atkins diet is being increasingly used in adults with epilepsy. ⺠The modified Atkins diet was helpful in 6 of 8 patients with JME within 1 month. ⺠Several patients found this therapy difficult to comply with over periods of time. ⺠Some seizure-free patients noted increased seizures during times of noncompliance.