Skip to main content Accessibility help
×
Home
Hostname: page-component-99c86f546-qdp55 Total loading time: 0.186 Render date: 2021-11-29T02:59:26.342Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Potential Benefit of Add-on Δ9-Tetrahydrocannabinol in Pediatric Drug-Resistant Epilepsy: A Case Series

Published online by Cambridge University Press:  29 June 2021

Magda Nowicki
Affiliation:
Department of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Sandrine Bourgeois-Tardif
Affiliation:
Centre de Recherche, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, QC, Canada Département de Neurosciences, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
Patrick L. Diaz
Affiliation:
Neurology Centre of Toronto, Toronto, Ontario, Canada
Francois Olivier Hebert
Affiliation:
Association Québécoise des Intervenants en Cannabis Médical (AQICM), Montréal, QC, Canada Clinique la Croix Verte, Montréal, QC, Canada Cannabis Innovation and Research Center, Université de Moncton, Moncton, NB, Canada
Nathalie T. Sanon
Affiliation:
Centre de Recherche, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, QC, Canada
Pierre-Olivier Champagne
Affiliation:
Centre de Recherche, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, QC, Canada Department of Pediatric Neurosurgery, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, QC, Canada
Philippe Major
Affiliation:
Neurology service, Department of Neurosciences and Pediatrics, CHU Sainte Justine, University of Montreal, Montreal, QC, Canada
Erick Sell
Affiliation:
Division of Neurology, Children’s Hospital of Eastern Ontario; University of Ottawa, Ontario, Canada
Jonathan Bitton
Affiliation:
Centre de Recherche, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, QC, Canada
Evan Lewis*
Affiliation:
Neurology Centre of Toronto, Toronto, Ontario, Canada
Alexander G. Weil*
Affiliation:
Centre de Recherche, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, QC, Canada Department of Pediatric Neurosurgery, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, QC, Canada
*
Correspondence to: Evan Lewis, BSC, MD, FRCP(C), Neurology Centre of Toronto, 491 Eglinton Ave W Suite 100, Toronto, ON, Canada, M5N 1A8. Email: evan.lewis@neurologycentretoronto.com; Alexander G Weil, MD, FRCSC, Centre Hospitalier Universitaire Sainte-Justine, Centre de Recherche, Room 3.17.100_6, 3175, Côte Sainte-Catherine, Montréal, Québec, Canada H3T 1C5. Email: alexandergweil@gmail.com
Correspondence to: Evan Lewis, BSC, MD, FRCP(C), Neurology Centre of Toronto, 491 Eglinton Ave W Suite 100, Toronto, ON, Canada, M5N 1A8. Email: evan.lewis@neurologycentretoronto.com; Alexander G Weil, MD, FRCSC, Centre Hospitalier Universitaire Sainte-Justine, Centre de Recherche, Room 3.17.100_6, 3175, Côte Sainte-Catherine, Montréal, Québec, Canada H3T 1C5. Email: alexandergweil@gmail.com

Abstract:

We present five cases of pediatric drug-resistant epilepsy (DRE) that failed management using high cannabidiol (CBD) doses, but had significant reduction in seizure frequency with reintroduction or increasing doses of tetrahydrocannabinol (THC). There is growing evidence supporting the use of whole-plant CBD-rich extracts (containing THC and other cannabinoids) in the treatment of pediatric DRE. Based on our experiences and reports in the literature, we propose that, in patients who fail management with an initial trial of high-dose CBD-focused therapy, there may be a role for add-on THC-focused formulations.

Résumé :

RÉSUMÉ :

Bienfait potentiel de l’adjonction de Δ9-tétrahydrocannabinol (THC) dans le traitement de l’épilepsie résistante aux médicaments chez les enfants : série de cas.

Seront exposés dans l’article cinq cas d’épilepsie résistante aux médicaments (ERM) chez des enfants qui se sont montrés réfractaires à l’administration de fortes doses de cannabidiol (CBD) mais chez qui la reprise ou l’augmentation des doses de THC ont permis une réduction importante de la fréquence des crises d’épilepsie. De plus en plus de données probantes étayent l’emploi d’extraits de plantes entières, riches en CBD (contenant du THC et d’autres cannabinoïdes) dans le traitement de l’ERM chez les enfants. D’après l’expérience des auteurs et la documentation médicale, il y aurait lieu d’adjoindre des préparations contenant du THC chez les patients qui se montrent réfractaires à un essai initial de CBD seul, à forte dose.

Type
Brief Communication
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Canadian Journal of Neurological Sciences Inc

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

co-first authors

**

co-senior authors

References

Tang, F, Hartz, AMS, Bauer, B. Drug-resistant epilepsy: multiple hypotheses, few answers. Front Neurol. 2017;8:119. doi: 10.3389/fneur.2017.00301 CrossRefGoogle ScholarPubMed
Elliott, J, DeJean, D, Clifford, T, et al. Cannabis-based products for pediatric epilepsy: an updated systematic review. Seizure. 2020;75:1822. doi: 10.1016/j.seizure.2019.12.006 CrossRefGoogle Scholar
McCoy, B, Wang, L, Zak, M, et al. A prospective open-label trial of a CBD/THC cannabis oil in dravet syndrome. Ann Clin Transl Neurol. 2018;5:1077–88. doi: 10.1002/acn3.621 CrossRefGoogle ScholarPubMed
Hausman-Kedem, M, Menascu, S, Kramer, U. Efficacy of CBD-enriched medical cannabis for treatment of refractory epilepsy in children and adolescents - An observational, longitudinal study. Brain Dev. 2018;40:544–51. doi: 10.1016/J.BRAINDEV.2018.03.013 CrossRefGoogle ScholarPubMed
Huntsman, RJ, Tang-Wai, R, Shackelford, AE. Cannabis for Pediatric Epilepsy. J Clin Neurophysiol Off Publ Am Electroencephalogr Soc. 2020;37:28. doi: 10.1097/WNP.0000000000000641 Google ScholarPubMed
Russo, EB. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. Br J Pharmacol. 2011;163:1344–64. doi: 10.1111/bph.2011.163 CrossRefGoogle ScholarPubMed
Rosenburg, EC, Patra, PH, Whalley, BJ. Therapeutic effects of cannabinoids in animal models of seizures, epilepsy, epileptogenesis, and epilepsy-related neuroprotection. Epilepsy Behav. 2017;70:319–27. doi: 10.1016/j.chemosphere.2012.12.037 CrossRefGoogle Scholar
Finlay, DB, Sircombe, KJ, Nimick, M, Jones, C, Glass, M. Terpenoids From Cannabis Do Not Mediate an Entourage Effect by Acting at Cannabinoid Receptors. Front Pharmacol. 2020;11:359. doi: 10.3389/fphar.2020.00359 CrossRefGoogle Scholar
Suraev, A, Lintzeris, N, Stuart, J, et al. Composition and use of cannabis extracts for childhood epilepsy in the australian community. Sci Rep. 2018;8:114. doi: 10.1038/s41598-018-28127-0 Google ScholarPubMed
Pamplona, FA, Coan, AC. Potential clinical benefits of CBD-rich Cannabis extracts over purified CBD in treatment-resistant epilepsy: observational data meta-analysis. bioRxiv. 2017. doi: 10.1101/212662 CrossRefGoogle Scholar

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Potential Benefit of Add-on Δ9-Tetrahydrocannabinol in Pediatric Drug-Resistant Epilepsy: A Case Series
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Potential Benefit of Add-on Δ9-Tetrahydrocannabinol in Pediatric Drug-Resistant Epilepsy: A Case Series
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Potential Benefit of Add-on Δ9-Tetrahydrocannabinol in Pediatric Drug-Resistant Epilepsy: A Case Series
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *