Late onset epilepsy associated with marijuana abuse: a case report with MRI findings

Area of Science:

• Neurology
• Toxicology
• Neuroimaging

Background:

• Epileptic seizures are a neurological disorder affecting millions globally.
• The association between marijuana use and seizures remains a subject of ongoing debate.
• Marijuana is the most commonly used illicit substance worldwide.

Observation:

• A 44-year-old male with a 26-year history of regular marijuana smoking presented with three episodes of generalized tonic-clonic seizures.
• Clinical examination revealed tachycardia, psychomotor slowing, and abnormal neurological signs including hyperreflexia and Babinski sign.
• Laboratory tests confirmed high levels of Δ-9-tetrahydrocannabinol (THC) in urine.

Findings:

• Electroencephalogram (EEG) results were normal, ruling out typical epileptic activity.
• Brain magnetic resonance imaging (MRI) demonstrated abnormal signal intensities in the right frontal lobe and basal ganglia.
• Seizures were controlled with anti-epileptic medication.

Implications:

• This case suggests a potential link between chronic marijuana abuse and the development of late-onset epilepsy.
• Vascular and toxic mechanisms related to Δ-9-tetrahydrocannabinol (THC) are proposed as potential causes for seizures in this context.
• Further research is warranted to elucidate the neurobiological effects of marijuana on seizure susceptibility.