Health-related quality of life in adults with drug-resistant focal epilepsy treated with modified Atkins diet in a randomized clinical trial.

Ketogenic diet, a high-fat, low-carbohydrate diet, is an established treatment for patients with severe epilepsy. We have previously reported a moderate reduction in seizure frequency after treatment with a modified Atkins diet. This study aimed to see whether dietary therapy impacts the patients' health-related quality of life (HRQOL). In a randomized controlled design, we compared the change in self-reported HRQOL among adults with difficult-to-treat epilepsy after a 12-week diet intervention. Thirty-nine patients with drug-resistant focal epilepsy (age 16 - 65 years) were randomized to eat a modified Atkins diet with maximum 16 grams of carbohydrate per day (diet group, n=19) or to continue eating habitual diet (control group, n=20). No changes to the other epilepsy treatments were allowed. Patient reported HRQOL was assessed with the Quality of Life in Epilepsy Inventory-89 (QOLIE-89). The diet group experienced a statistically significant improvement in mean total score of QOLIE-89 of 10 points compared to controls (p=0.002). Moreover, although not statistically significant when using a cut-off of 50% seizure reduction, our data suggest an association between diet-induced reduction in seizure frequency and improvement of HRQOL. The improvement in HRQOL was not associated with diet-induced weight reduction.