Use of Cannabidiol in pediatric patients with refractory epilepsy of different etiologies

Background: Cannabidiol (CBD) is a non-psychoactive substance of Cannabis sativa effective in refractory epilepsy due to Dravet syndrome, Lennox-Gastaut syndrome and Tuberous Sclerosis Complex, with few studies in other etiologies. There are studies that show benefit in the mutual use of clobazam and CBD.

Objective: To analyze the response of pediatric refractory epilepsy of different etiologies after CBD introduction.

Methods: Analysis of data from medical records using measures of central tendency and dispersion (average and standard deviation) and Student's T-test.

Results: In a total of 5 patients, 3 have Doose syndrome, 1 has Miller-Dieker syndrome and 1 has epileptic encephalopathy of unclear etiology, the last 2 with cerebral palsy (CP). Age at CBD introduction was 3±1.9 years. Time of use in months of 9±5. Total anticonvulsants in optimized dose of 3±1, all patients using clobazam in association. Dosage of CBD in mg/kg/day of 11.6±11.1. Maximum number of daily crises before was 28±15 and after 2±1.2, with p < 0.05 (0.002). Number of admissions before of introduction was 2.4±0.9 and after 0.8±0,9, with p <0.05 (0.03). There was an improvement in development in children with Doose syndrome and in social interaction in the children with CP. Reduction of other medications possible in 2 of the patients. One patient had memory impairment, with no other identified side effects.

Conclusions: CBD in pediatric refractory epilepsy needs more studies in different kinds of etiologies. This study suggests that there is benefit in controlling the number of seizures and reduction of hospitalizations, also improving quality of life. The association of clobazam and CBD is encouraged by the literature, which is a combination used in all patients in this study.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
18 September 2023