For centuries, the major cause behind epileptic seizures remained a mystery raising all sorts of speculations. From demons taking possession of the body to the lack of a proper diet, epilepsy has challenged curious scientific minds.
Fortunately, today we know that epilepsy is associated with an abnormal level of electrical activity within the brain.
In most cases, epilepsy is accompanied by uncontrollable seizures, convulsions, loss of consciousness, impact on sensory perception, sensitivity to certain audio and visual gestures, etc.
Even though many anti-epileptic medications are available in the market today, thereâs no cure in the market today that is 100% accurate in eliminating epileptic seizures.
In recent years, medical marijuana has become a great alternative to traditional treatment methods when it comes to bringing the intensity and reoccurrence of epileptic seizures and associated symptoms to a manageable level.
However, before further exploring the effectiveness of medical marijuana in epilepsy treatment, it is crucial to get a thorough idea about what exactly epilepsy is.
What exactly is epilepsy?
For better classification and identification of the disorder, epilepsy is divided into four main types depending upon the types of seizures a patient is having.
- Generalized Epilepsy
- Focal Epilepsy
- Generalized and focal epilepsy
- Unknown if generalized or focal epilepsy
It is important to note that even epileptic seizures can be classified into certain types. Each type of seizure is associated with a specific type of epilepsy. Some common types of epileptic seizures include,
- Simple partial (focal) seizures or âaurasâ: The auras are more primary type of seizures that can act as a warning for upcoming severe seizures. Common symptoms include a rising feeling in the stomach accompanied by twitching, tingling in the arms and legs, body stiffness, etc.
- Complex partial (focal) seizures: These seizures are a more advanced type of epileptic seizures and chances are that the person suffering from such a seizure wonât remember it after it has passed. The seizure is associated with making random body movements and a loss of self-awareness.
- Tonic seizure: The patient will suddenly feel all their body muscles becoming stiff.
- Grand Mal seizures: Also known as tonic-clonic seizures, the patient completely loses control of their body, they may become unconscious and fall to the floor. The limbs may jerk and flail while the patient loses control of their bowel/bladder with the tendency to bite their tongue/cheeks.
- Myoclonic seizure: This type of seizure may feel like a sudden electric shock passing through the body. The body will suddenly twitch but the seizure will only last a few seconds.
- Clonic seizures: The limbs may jerk and flail while the patient loses control of their bowel/bladder with the tendency to bite their tongue/cheeks.
- Atonic seizures: These seizures work in opposite to the clonic seizure as common symptoms include sudden relaxation of body muscles leading to body imbalance.
- Petit Mal seizures: Also known as the âabsencesâ, these seizures are quite common among young children and may happen several times a day. The seizure is categorized as a loss of awareness which the patient wonât remember.
âStatus epilepticusâ is a condition where the seizure lasts for a long time leading to severe brain damage or even death.
According to a careful estimate, around 50 million people across the globe have epilepsy. More than 3 million adults and 470,000 children in the US alone are diagnosed with epilepsy.
It is important to note that both stress and inflammation play a crucial role in the development or gradual progression of epilepsy. Once the neuroinflammation reaches a certain point, the lesions are formed in the nervous system injuring the neuronal tissues.
Modern-day treatments for epilepsy
Unfortunately, there is no yet known cure for epilepsy. The only treatment available across the world focuses on managing the symptoms of epilepsy instead of treatment. Following are some proven modern-day treatment streams for epilepsy,
- Anti-epileptic drugs (AEDs) are the primary mode of treatment and are known to have sedative effects.
- A change in diet leads to lowering the carbohydrate content and introducing more ketogenic dietary choices.
- Surgery to remove a particular small portion of the brain responsible for causing seizures.
Inserting a small electrical device within the body can help in managing seizures.
Can cannabis help for Epilepsy?
This might be a bit surprising for some of the readers but the concept of using medical marijuana to treat or subdue symptoms of epileptic seizures is something that has been discussed since the 1970âs.
In modern times, we now have concrete evidence in favor of medical marijuana being effective in managing the symptoms associated with Dravet syndrome or Lennox-gault syndrome.
Both these syndromes are a complex and incurable form of childhood epilepsy. Over the years, both these disorders have become treatment-resistant to traditional treatment methods.
However, we now have Schedule V CBD-based Epidiolex available for prescription in the United States. The drug is known to effectively manage severe epileptic symptoms associated with Dravet syndrome or Lennox-gault syndrome.
But why exactly traditional AEDs doesnât work effectively? Well, one explanation is that the AEDs are not compatible with CYP450, CYP2C9, CYP3A, CYP2C19, and CYP2D6 enzymes.
These enzymes are responsible for the metabolism of AEDs within the body. Scientifically, it has been proven that many individuals who are diagnosed with epilepsy have gene mutations specifically targeting these enzymes.
In other words, the AEDs are ineffective for such patient as their body wonât be able to metabolize these drugs in the first place.
Plus, AEDs are known to cause addiction, tremors, fatigue, headache, vomiting, brain âfogâ and death in case of an overdose.
Considering all of this, cannabis is a great alternative to these drugs with far fewer adverse effects leading to lowering the need for opting for an invasive treatment technique.
How to consume cannabis and are âspecial formulationsâ even good?
Perhaps one of the most prominent benefits of focusing on a cannabis-based treatment is the ability to consume your prescribed medications in more than one way.
In the case of cannabis, sublingual, ingestion, and suppositories are some of the most prominent modes of ingestion.
Also, you can opt for specific dosing methods as well. For example, tinctures are super easy to measure and have a quick onset of 30-60 minutes with 45 minutes being the average time.
You can even go with delicious cannabis-infused edibles that are slow with their on-set but when it comes to long-lasting effects and potency, there is no competition.
Now, let us talk about some of the special formulations and what to keep in mind. Avoiding Artisanal CBD products would be the right thing to do as these products have THC present in a ratio that can induce seizures.
It is not like consuming THC even in small fractions will have adverse effects on your body. THC in minute concentration can be great because of its sedative properties leading to lowering the amount of CBD that may required for chronic pain management and addiction to sedatives.
Products that are rich in CBD are ideal when it comes to managing the symptoms associated with epileptic seizures. A small amount of CBC, CBDV, THCA, and CBDA in addition will also have beneficial effects.
Even some terpenes like linalool and myrcene are known to have sedative and anti-inflammatory effects that are great for patients diagnosed with advanced types of epileptic seizures.
Flavinoids are not far behind as well. Quercetin and Kaempfrol are known to display neuroprotective properties but studies are still underway to further explore this treatment stream.
In the end, we have the Epidiolex which is now approved to be prescribed within the US. The only thing you need to follow carefully is the prescribed dosing method and amount.
A critical overview of cannabis and epilepsy: Pros & Cons
Just like any other effective treatment method available in the market today, medical marijuana does have a set number of pros and cons when it comes to epilepsy treatment. Letâs take a look at the pros first,
- CBD desensitizes the TRPV1 (vanilloid receptor) responsible for detecting pain and heat leading to a reduced neuronal excitability.
- Studies have revealed that those with epilepsy display lower levels of anandamide in their cerebrospinal fluid. Cannabinoids like CBD may help enhance anandamide signaling.
- The sedative and anti-inflammatory effects of high doses of CBD may help reduce neuronal excitability and help manage other issues like insomnia, anxiety, and chronic pain.
- High concentrations of CBD block calcium ion channels and antagonize GPR55, CB1, and CB2 receptors. This produces the CBDâs anti-convulsant properties.
- CBD acts as an anti-inflammatory agent further lowering the chances of permanent or partial brain damage.
Now that we know some prominent pros, are there any cons? Yes, hereâs a list of potential cons associated with the use of medical cannabis for epilepsy treatment,
- CBD may not be suitable for all types of epilepsy and may, in some cases, make seizures worse. This may be the case with the cannabinoids THC and THCV (or some of their analogs)
- CBD desensitizes the enzyme CYP450, which can further cause interference with the metabolism of many anti-epileptic drugs (AEDs).
So, does medical marijuana have any sort of beneficial impact on epilepsy treatment? From what we have studied so far the scientific evidence suggests that yes, medical cannabis does infact prove to be a great mode of treatment for patients suffering from complex types of epileptic seizures.
The approval of cannabis-based Epidiolex to be prescribed within the US for managing epileptic seizures is a piece of concrete evidence in favor of this.