Medical Cannabis for Intractable Epilepsy in Childhood: A Review

Ben‐Zeev, Bruria

doi:10.5041/rmmj.10387

Cited by 16 publications

(7 citation statements)

References 51 publications

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“…There is skepticism about the presence of an entourage effect of the constitutive pharmaceuticals within CBMPs, particularly in the setting of epilepsy. 36 In the present study the reduction in seizure frequency was comparable between those treated with CBD isolate oils and broad-spectrum CBD. This suggests, that despite preclinical evidence suggestive of anticonvulsant effects of minor cannabinoids, terpenes, and flavonoids these had little additional effect at the doses administered in the present study.…”

Section: Discussionsupporting

confidence: 61%

Clinical Outcome Data of Children Treated with Cannabis-Based Medicinal Products for Treatment Resistant Epilepsy—Analysis from the UK Medical Cannabis Registry

et al. 2022

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Background There is a paucity of high-quality evidence of the efficacy and safety of cannabis-based medicinal products in treatment of treatment-resistant epilepsy (TRE) in children. Methods A case series of children(<18 years old) with TRE from the UK Medical Cannabis Registry was analysed. Primary outcomes were ≥50% reduction in seizure frequency, changes in the Impact of Paediatric Epilepsy Score(IPES) and incidence of adverse events. Results Thirty-five patients were included in the analysis. Patients were prescribed during their treatment with the following-CBD isolate oils(n=19), CBD broad-spectrum oils(n=17), and CBD/Δ9-THC combination therapy(n=17). Twenty-three(65.7%) patients achieved a ≥50% reduction in seizure frequency. 94.1%(n=16) of patients treated with CBD and Δ9-THC observed a ≥50% reduction in seizure frequency compared to 31.6%(n=6) and 17.6%(n=3) of patients treated with CBD isolates and broad-spectrum CBD products respectively(p<0.001). Twenty-six(74.3%) adverse events were reported by 16 patients(45.7%). The majority of these were mild(n=12; 34.2%) and moderate(n=10; 28.6%). Conclusions The results of this study demonstrate a positive signal of improved seizure frequency in children treated with CBMPs for TRE. Moreover, the results suggest that CBMPs are well-tolerated in the short term. The limitations mean causation cannot be determined in this open-label, case series.

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Section: Discussionsupporting

confidence: 61%

Clinical Outcome Data of Children Treated with Cannabis-Based Medicinal Products for Treatment Resistant Epilepsy—Analysis from the UK Medical Cannabis Registry

et al. 2022

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“…The infants suffer from cognitive decline, motor, and behavioral abnormalities 3 , 4 . Other presentations of epilepsy and additional indications, such as autism, and inflammatory bowel disease (IBD) have been reported recently 5 – 7 The non-psychoactive substance cannabidiol (CBD) is used for these indications, whereas chemotherapy-induced nausea and vomiting (CINV) are treated with the psychoactive D-9-Tetrahydrocannabinol (THC) and its analogues 8 – 10 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of medical cannabinoids in children: a systematic review and meta-analysis

Treves

Mor

Allegaert

et al. 2021

Sci Rep

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Despite the increased use of medical cannabinoids, the efficacy and safety of the treatment among children remain uncertain. The objective was to study the efficacy and safety of medical cannabinoids in children. The search included studies through 11-May-2020. Selection criteria included studies evaluating efficacy and safety outcomes of medical cannabinoids (tetrahydrocannabinol, cannabidiol and other cannabis derivatives) versus control in children, independently assessed by two reviewers. Eight studies were included, all of which are randomized controlled trials. Cannabidiol is associated with 50% reduction in seizures rate (Relative Risk (RR) = 1.69, 95% CI [1.20–2.36]) and caregiver global impression of change (Median Estimated difference = (− 1), 95%CI [− 1.39–(− 0.60)]) in Dravet syndrome, compared to placebo. While cannabidiol was associated with a reduction in reported seizure events (RR = 0.59, 95% CI [0.36–0.97]), no association was found in products contained also tetrahydrocannabinol (RR = 1.35, 95% CI [0.46–4.03]). Higher dose of cannabidiol was associated with decreased appetite (RR = 2.40, 95% CI [1.39–4.15]). A qualitative assessment suggests that medical cannabinoids might be associated with adverse mental events. In conclusion, cannabidiol is associated with clinical improvement in Dravet syndrome. However, cannabidiol is also associated with decreased appetite. Adverse mental events were reported as well, however, more research should be performed to assess well this outcome.

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“…There is currently strong evidence for pure CBD in the treatment of refractory epilepsy, irritability associated with ASD, Tourette syndrome, and spasticity [11]. It must be considered that epilepsy is one of the most frequent comorbidities in ASD, affecting 10-30% of children [12]. Despite receiving medical treatment, 40% present maladaptive behavior, severely impacting their quality of life [11].…”

Section: Discussionmentioning

confidence: 99%

experiencia con Cannabidiol en el trastorno del espectro autista

Ríos¹,

Miranda

Ríos³

et al. 2021

REV-SEP

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Introducción: Los trastornos del espectro autista (TEA) están constituidos por un conjunto de manifestaciones heterogéneas del neurodesarrollo caracterizados por déficits persistentes de la comunicación e interacción social; patrones repetitivos y restringidos de la conducta, actividades e intereses que limitan la vida de estos pacientes y sus familiares. Existe un creciente interés por el uso de Cannabidiol debido a su efectividad con respecto al control de las crisis epilépticas y cambios positivos en la conducta, en la irritabilidad o agresividad asociadas a TEA, en la capacidad receptiva y expresiva del lenguaje, el estado de ánimo y la calidad de sueño. Caso clínico: niño de 3 años que demuestra características compatibles con TEA y crisis de tipo ausencias en el que se propuso establecer un programa de intervención farmacológica en base a la utilización de cannabidiol, asociado a terapias fonoaudiológicas y psicomotoras. Evolución: Al culminar el primer año de tratamiento con un seguimiento exhaustivo se reportan avances significativos, con disminución o ausencia de episodios de desconexión o parpadeos, mejor adaptación funcional, mejoría en adquisición del lenguaje y mejor interrelación. Tolera de mejor manera los espacios cerrados, sigue órdenes y rutinas sencillas. El terapista indica grandes avances y termina su primer año de escolarización con logros significativos. El estudio EEG en mejores condiciones con respecto a los anteriores, con una actividad de base mejor estructurada y disminución de la actividad epileptógena frontal. Conclusión: El tratamiento brindado actualmente con cannabidiol ha resultado eficaz mejorando las condiciones de vida en el caso presentado.

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Medical Cannabis for Intractable Epilepsy in Childhood: A Review

Cited by 16 publications

References 51 publications

Clinical Outcome Data of Children Treated with Cannabis-Based Medicinal Products for Treatment Resistant Epilepsy—Analysis from the UK Medical Cannabis Registry

Clinical Outcome Data of Children Treated with Cannabis-Based Medicinal Products for Treatment Resistant Epilepsy—Analysis from the UK Medical Cannabis Registry

Efficacy and safety of medical cannabinoids in children: a systematic review and meta-analysis

experiencia con Cannabidiol en el trastorno del espectro autista

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