Adding medium chain triglycerides (MCTs) or triheptanoin to the diet to ameliorate metabolic deficiencies in treatment-resistant epilepsy may have a protective effect on focal unaware seizures, Australian research suggests.
A small prospective study conducted at the the Royal Melbourne Hospital found that adding MCTs to the diet appeared feasible, safe and tolerated.
The study, led by Dr Karin Borges, Head of the Neurological Disorders and Metabolism Laboratory, University of Queensland, comprised 34 patients with epilepsy who experienced at least two seizures per 28 days despite treatment with at least one antiseizure drug. They were randomised to either an MCT (triglycerides of octanoate or decanoate) or triheptanoin (triglycerides of heptanoate) taken in an oil form at three daily meals.
Patients were given a titration scheme to increase their dose over a period of three weeks to 35% of energy intake (based on 4-day food diaries), a maximum of 100 mL or their maximal tolerated dose in the case of gastrointestinal disturbances.
A 12-week maintenance phase was followed by down titration over three weeks and cessation of treatment.
The study found an encouraging 50% reduction in seizure frequency in five of 11 (45%) participants treated with MCTs and specifically focal unaware seizures.
One of nine (11%) patients who completed the trial treated with triheptanoin also had a 50% reduction in seizure frequency.