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Cannabis for Pediatric Epilepsy

Richard J Huntsman1, Richard Tang-Wai2, Alan E Shackelford3

  • 1Division of Paediatric Neurology, Department of Pediatrics, University of Saskatchewan, Royal University Hospital, Saskatoon, Saskatchewan, Canada.

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
|January 3, 2020
PubMed

Insights

Cannabidiol (CBD) and cannabis extracts show promise in reducing seizures for children with treatment-resistant epilepsy. However, more research on dosing and pediatric pharmacokinetics is needed for widespread therapeutic use.

Area of Science:

  • Neurology
  • Pharmacology
  • Cannabinoid Science

Background:

  • Epilepsy affects many children, with a significant portion resistant to conventional treatments.
  • The endocannabinoid system plays a role in epilepsy, and cannabinoids like CBD have demonstrated anticonvulsant properties.
  • Cannabis-based therapies have a long history of use for various conditions, including epilepsy.

Purpose of the Study:

  • To review the efficacy of cannabis-based therapies, particularly cannabidiol (CBD), in treating drug-resistant epilepsy in children.
  • To evaluate the current evidence supporting the use of pharmaceutical-grade CBD and cannabis herbal extracts for pediatric epilepsy.

Main Methods:

  • Review of in vitro and in vivo studies on cannabinoid anticonvulsant properties.
  • Analysis of clinical studies, including randomized controlled trials and observational studies, on CBD and cannabis extracts in pediatric epilepsy.
  • Assessment of data on seizure frequency reduction and challenges in therapeutic application.

Main Results:

  • Both pharmaceutical-grade CBD and CBD-enriched cannabis extracts show benefits in reducing seizure frequency in treatment-resistant pediatric epilepsy.
  • Cannabis herbal extracts may offer greater efficacy, but supporting studies are often retrospective or small-scale.
  • Randomized controlled trials of pharmaceutical-grade CBD in Dravet and Lennox-Gastaut syndromes demonstrated efficacy comparable to other anticonvulsants.

Conclusions:

  • Cannabis-based therapies, especially CBD, are effective in managing treatment-resistant epilepsy in children.
  • Further research is required to establish appropriate dosing guidelines and understand pediatric pharmacokinetics for these therapies.
  • Challenges remain in the authorization and widespread clinical adoption of cannabis-based treatments for pediatric epilepsy.

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