Comparison of Efficacy of LGIT and MAD Among Children With Drug Resistant Epilepsy

Comparison of Efficacy of Low Glycemic Index Therapy and Modified Atkins Diet Among Children With Drug Resistant Epilepsy: A Randomized Non-inferiority Trial

To compare the efficacy of two less restrictive dietary therapies - LGIT and MAD, used for treatment of drug resistant epilepsy in children

Up to one third of patients with epilepsy progress to drug resistant epilepsy (DRE). Current treatment options for DRE include epileptic surgery and dietary therapy. Classic KD (Ketogenic diet) is the most studied dietary therapy but the stringent restrictions and practical difficulty makes it difficult to follow. So less restrictive diets like MAD and LGIT were introduced. These are reported to have less adverse effects also. But no published study has ever been conducted comparing these two diets head to head.

Inclusion Criteria:

• Children aged 1-15 years with drug resistant epilepsy
• Willing to come for regular follow-up according to study protocol Drug resistant epilepsy defined as
• Seizure frequency >4 seizures per month, while on optimal doses of at least 2 prescribed antiepileptic drugs
• For West syndrome, drug resistant epilepsy will be defined as more than 4 clusters of spasms per month despite treatment with antiepileptic drugs and either ACTH(Adrenocorticotrophic hormone) or Vigabatrin

Exclusion Criteria:

• Surgically remediable causes for DRE

• Inborn errors of metabolism

• Previously received KD, MAD or LGIT

• Known case of

  1. Chronic kidney disease
  2. Chronic liver disease/GI illness
  3. Congenital/acquired heart disease
  4. Chronic respiratory illness