April 4, 2014: MAD for Seizures

Interested in submitting an E-Pearl?
Brought to you by the Residents & Fellows Section of Neurology®.

APRIL 4, 2014

The ketogenic diet has been studied, recognized, and used as an alternative to antiepileptic drugs (AEDs) since the 1920’s. Recently, the modified Atkins diet (MAD) has emerged as a less restrictive, more palatable but effective alternative to the ketogenic diet. Studies in patients with intractable epilepsy have demonstrated that the MAD is well tolerated, produces ketosis, and is effective in improving seizure control (1). Such dietary therapies have historically been considered as a treatment alternative primarily in pediatric patients with severe medically refractory epilepsy. These therapies, however, are gaining traction amongst adults with intractable epilepsy (2). In these patients who remain refractory to AEDs, consideration of the MAD and ketogenic diets may provide an appealing alternative in select cases.


  1. Kossoff EH, McGrogan JR, Bluml RM, et al. A modified Atkins diet is effective for the treatment of intractable pediatric epilepsy. Epilepsia 2006; 47: 421-424.
  2. Kossoff EH, Rowley H, Sinha SR, et al. A prospective study of the modified Atkins diet for intractable epilepsy in adults. Epilepsia 2008; 49: 316-319.

Submitted by Roy Strowd, MD, Clinical neuro-oncology Fellow, Johns Hopkins Hospital, Baltimore, MD.

Dr. Strowd is a member of the Resident and Fellow Section of Neurology.

For more clinical pearls and other articles of interest to neurology trainees, visit Neurology. Listen to this week's Neurology Podcast.


Forgot password?