Cannabidiol for treatment of refractory childhood epilepsies: Experience from a single tertiary epilepsy center in Slovenia

Epilepsy Behav. 2018 Apr;81:79-85. doi: 10.1016/j.yebeh.2018.02.009. Epub 2018 Mar 8.

Abstract

Purpose: Refractory epilepsies in children present a major burden for patients and their families. Cannabidiol (CBD) has been suggested as a potential treatment for refractory epilepsies. The aim of this study was to evaluate the effectiveness of add-on therapy with CBD for the treatment of refractory childhood epilepsies.

Method: Patients with childhood-onset refractory epilepsy, treated at the tertiary epilepsy center of the University Children's Hospital Ljubljana, Slovenia, were included in the study. Add-on therapy with CBD was initiated once the child's epilepsy was categorized as pharmacoresistant to other antiepileptic drugs/therapies. The dosage of CBD was gradually increased to at least 8mg/kg/day. The effect of CBD treatment was evaluated by the reduction in seizure burden and presence of side effects (positive and negative). Serial electroencephalography was performed in some children.

Results: Sixty-six patients were included in the analysis. Thirty-two (48.5%) patients had a more than 50% improvement regarding seizure burden, 14 of whom (21.2%) became seizure-free. None of the patients reported worsening of seizure frequency, but CBD had no effect in 15 (22.7%) patients. Some patients reported less vigorous seizures, shorter duration of seizures, shorter time to recovery, and other positive side effects of CBD treatment. Adverse effects were reported in 5/66 children.

Conclusions: In our cohort of patients, CBD was found to have potential benefits as add-on therapy for refractory childhood epilepsies, mainly by reducing seizure burden.

Keywords: Antiepileptic drugs; Cannabidiol; Electroencephalography; Epilepsy; Pharmacoresistant; Refractory.

MeSH terms

  • Adolescent
  • Anticonvulsants / therapeutic use*
  • Cannabidiol / therapeutic use*
  • Child
  • Child, Preschool
  • Drug Resistant Epilepsy / drug therapy*
  • Electroencephalography
  • Female
  • Humans
  • Male
  • Seizures / drug therapy*
  • Slovenia

Substances

  • Anticonvulsants
  • Cannabidiol