Skip to main content
. 2018 Nov 7;2018(11):CD001903. doi: 10.1002/14651858.CD001903.pub4

El‐Rashidy 2013.

Methods Single‐centre randomised controlled trial to comparing two different dietary interventions (MAD and classic KD in form of 4:1 liquid diet) and a control group (AED polytherapy).
Participants 40 children aged 12‐36 months (mean 27.13, SD 6.63) with symptomatic intractable epilepsy. Study undertaken in Egypt
Interventions Participants were randomised into 1 of 3 groups; MAD (15 participants), KD (10 participants) and control (polytherapy) (15 participants). Data were collected at 3 and 6 months
Outcomes
  • Reduction in seizure frequency

  • Adverse effects

  • Attrition rate

Notes 2 participants in the MAD group dropped out of the trial as they could not accept the diet and experienced weight loss. From the results, it could be inferred that these participants dropped out between the 3‐ and 6‐month reviews. 2 participants from the classic KD group dropped out due to intolerance; however, it was unclear when these participants dropped out.
Exclusion criteria: children < 1 year, diagnosed with idiopathic epilepsy or with other systemic chronic conditions
4:1 refers to 4 g fat to 1 g of carbohydrate and protein combined.
No external funding support was received for this study beyond the treating hospital (Children's hospital, Faculty of Medicine, Ain Shams University).
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Although the paper stated that participants were 'randomly assigned', there was no information regarding how the randomisation sequence was generated.
Allocation concealment (selection bias) Unclear risk There was no information suggesting whether allocation was concealed or not.
Blinding (performance bias and detection bias) 
 All outcomes High risk Blinding was not discussed in this paper but considering the design of the study, binding of participants and study personnel does not seem possible.
Incomplete outcome data (attrition bias) High risk Study attrition was reported but ITT analysis was not carried out. Reasons for dropouts were likely to be related to interventions.
Selective reporting (reporting bias) Unclear risk Emailed author regarding protocol, awaiting response from co‐authors. Protocol currently unavailable
Other bias High risk No measure of seizure frequency reported at baseline. 20% of participants in the classic KD group had infantile spasms.