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Epilepsy Res. 2019 Mar;151:31-39. doi: 10.1016/j.eplepsyres.2019.02.001. Epub 2019 Feb 5.

Cannabis for refractory epilepsy in children: A review focusing on CDKL5 Deficiency Disorder.

Author information

1
UWA Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia(1); Telethon Kids Institute, University of Western Australia, Perth, WA, Australia(2). Electronic address: Tristan.Dale@telethonkids.org.au.
2
Telethon Kids Institute, University of Western Australia, Perth, WA, Australia(2); School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia(3). Electronic address: Jenny.Downs@telethonkids.org.au.
3
Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, MA, USA(4). Electronic address: Heather.Olson@childrens.harvard.edu.
4
Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, MA, USA(4). Electronic address: AnnMarie.Bergin@childrens.harvard.edu.
5
Telethon Kids Institute, University of Western Australia, Perth, WA, Australia(2). Electronic address: Stephanie.Smith@telethonkids.org.au.
6
Telethon Kids Institute, University of Western Australia, Perth, WA, Australia(2). Electronic address: Helen.Leonard@telethonkids.org.au.

Abstract

Severe paediatric epilepsies such as CDKL5 Deficiency Disorder (CDD) are extremely debilitating, largely due to the early-onset and refractory nature of the seizures. Existing treatment options are often ineffective and associated with a host of adverse effects, causing those that are affected to seek alternative treatments. Cannabis based products have attracted significant attention over recent years, primarily driven by reports of miraculous cures and a renewed public preference for 'natural' therapies, thus placing intense pressure on health professionals and the government for regulatory change. This study provides a comprehensive overview of the potential role for cannabis in the treatment of CDD. Key areas discussed include the history, mechanism of action, efficacy and safety of cannabis based preparations as well as the burden related to CDD. The evidence supports the use of cannabinoids, especially cannabidiol, in similar forms of refractory epilepsy including Dravet and Lennox-Gastaut syndromes. Evidence for cannabinoids specifically in CDD is limited but growing, with multiple anecdotal reports and an open-label trial showing cannabidiol to be associated with a significant reduction in seizure activity. This review provides the first comprehensive overview of the potential role for cannabis based preparations in the treatment of CDD and provides justification for further clinical and observational research.

KEYWORDS:

CDKL5 Deficiency Disorder; Cannabidiol; Cannabis; Encephalopathy; Epilepsy; Paediatric

[Indexed for MEDLINE]

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