Cannabis for Pediatric Epilepsy

被引:25
作者
Huntsman, Richard J. [1 ]
Tang-Wai, Richard [2 ]
Shackelford, Alan E. [3 ]
机构
[1] Univ Saskatchewan, Royal Univ Hosp, Div Paediat Neurol, Dept Pediat, 103 Hosp Dr, Saskatoon, SK S7H 0A1, Canada
[2] Loma Linda Univ, Dept Pediat, Div Child Neurol, Loma Linda, CA 92350 USA
[3] Amarimed Colorado, Denver, CO USA
关键词
Epilepsy; Pediatric; Cannabis; Tetrahydrocannabinol; Cannabidiol; RESISTANT EPILEPSY; CHILDHOOD EPILEPSY; NERVE-STIMULATION; ILAE COMMISSION; IN-VITRO; ANTICONVULSANT; SEIZURES; DELTA-9-TETRAHYDROCANNABINOL; EXTRACTS; PHYTOCANNABINOIDS;
D O I
10.1097/WNP.0000000000000641
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Epilepsy is a chronic disease characterized by recurrent unprovoked seizures. Up to 30% of children with epilepsy will be refractory to standard anticonvulsant therapy, and those with epileptic encephalopathy can be particularly challenging to treat. The endocannabinoid system can modulate the physiologic processes underlying epileptogenesis. The anticonvulsant properties of several cannabinoids, namely Delta (9)-tetrahydrocannabinol and cannabidiol (CBD), have been demonstrated in both in vitro and in vivo studies. Cannabis-based therapies have been used for millennia to treat a variety of diseases including epilepsy. Several studies have shown that CBD, both in isolation as a pharmaceutical-grade preparation or as part of a CBD-enriched cannabis herbal extract, is beneficial in decreasing seizure frequency in children with treatment-resistant epilepsy. Overall, cannabis herbal extracts appear to provide greater efficacy in decreasing seizure frequency, but the studies assessing cannabis herbal extract are either retrospective or small-scale observational studies. The two large randomized controlled studies assessing the efficacy of pharmaceutical-grade CBD in children with Dravet and Lennox-Gastaut syndromes showed similar efficacy to other anticonvulsants. Lack of data regarding appropriate dosing and pediatric pharmacokinetics continues to make authorization of cannabis-based therapies to children with treatment-resistant epilepsy challenging.
引用
收藏
页码:2 / 8
页数:7
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