In children aged 1yr -18 years with refractory epilepsy Modified Atkins diet as add on to ongoing AED therapy would not be inferior compared to ketogenic diet ** in terms of seizure reduction from baseline seizure frequency at 6 months

Primary objective:

To compare the efficacy of Modified Atkins diet compared to Ketogenic diet * in children aged 1 year to 18 years of age with refractory epilepsy on anti epileptic drugs at 6 months of diet intake in terms of percentage of seizure reduction from base line.

Secondary objective:

Proportion of patients who achieve > 50% seizure reduction from baseline after 6 months in both groups To evaluate the nature of adverse events in both the groups

Inclusion Criteria:

• Children aged 1-18 years with refractory epilepsy*
• Willing to come for regular follow up
• No motivational or psychosocial issues in the family which would preclude compliance with the diet

Exclusion Criteria

• Surgically remediable cause for refractory epilepsy
• Suspected mitochondrial disorder or diagnosed with a disorder in which high fat diet is contraindicated
• Previously received ketogenic diet or modified Atkins diet
• Chronic systemic disease like chronic kidney disease, chronic liver disease, heart disease (congenital and acquired) and chronic respiratory illness