Hi @lisalucier We tried the modified atkins for about 9 months. I would say the first 3 months we saw a dramatic decrease in break through seizures and in general while my son was on the modified atkins he was "clearer" if that makes sense. We eventually ended up discontinuing the diet because it was so restrictive and hard to maintain as I work full time and my son was 10/11 at the time. We are investigating trying Keto again in addition to his VNS. I feel that with seizure disorders there are so many opportunities for trial and error until you find a mix that works to control seizure activity. My son has experienced moderate level of success with the modified atkins and the VNS. Banzel is a staple for him as well. I am hopeful that now with the VNS if we go back to the diet we will be able to wean off of the medication. That's always my goal for him, to have seizure control without medication.