Medical Cannabis and Epilepsy

Epilepsy and Medical Cannabis

Epilepsy is an illness whom primary symptom is a seizure. There is different types of seizures due to different factors. Cannabis, also known as Marijuana, has been found to have medicinal properties and helpful in the treatment of different illness. One of this illness is Epilepsy, due that cannabis has anti-seizure properties

Epilepsy Explained by the Epilepsy Foundation

The Epilepsy Foundation (EF) defines Epilepsy as a chronic disorder which the main characteristic is recurrent of unprovoked seizures. The International League Against Epilepsy Organization (ILAP) expands this definition by categorizing epilepsy as a brain disorder characterized by the enduring predisposition to generate epileptic seizure and the neurologic cognitive, phycological and social consequences of this condition.

According to the EF, 3.4 million people in the United States suffer from Epilepsy, being 470,000 of them children. They add to that number that 1 in 26 people in the US will suffer from this illness at some point in their lives. Two shocking statistics from them is that 6 out of 10 cases of epilepsy, the cause is unknown; and a third of people with epilepsy live with uncontrollable seizures due that there is no available treatment that can help them control their seizures.

The ILAP typify epilepsy by having one of the following requirements:

  • Two or more unprovoked seizures within 24 hours
  • An unprovoked seizure and a probability of further seizures with a probability of recurrence of at least 60 % after two unprovoked seizure, occurring for the next 10 years.
  • A diagnosis of epilepsy syndrome

Epilepsy symptoms vary in each patient, but seizers are the most evident and important of them. Some of the most common symptoms are:

  • Convulsion with no fever
  • Short blackouts or confused memory
  • Short periods of unresponsive to instructions or questions
  • Suddenly becoming stiff with no apparent reason
  • Repetitive movements that seem inappropriate
  • Short time seems to be dazed and unable to communicate
  • Becoming fearful for no apparent reason, also it might be panic or becoming angry
  • Peculiar changes in senses, especially smell, touch, and hearings

Epilepsy has no cure, most of the treatments are meant to manage the illness. The most common treatment is the use of medicaments named anti-epileptic drugs (AED). These medicaments tried to stabilize the brain’s electric activity, which is one the of causes of seizures. According to Epilepsy Scotland (ES), the medicament to use is based on the type of seizure epilepsy has. Not all patients react equally to the drugs, but AED seems to help control seizures in 70% of cases. As many drugs, AED’s have side effects, especially during the first few weeks of starting the treatment. The main side effects during this weeks are feeling tired, upset stomach or discomfort, dizziness, blurred vision, thinning bones, clumsiness, trouble thinking, trouble talking, and trouble remembering things. This side effect could be tolerated if the medication is gradually increased. Also, the side effects stop after a few weeks of taking the medicine.

Surgery is another alternative treatment to help stop seizures if an underlying brain condition is causing the seizures, for ES only a few number of cases could consider surgery as a treatment. An alternative treatment, besides medication and surgery, is Vagus Nerve Stimulation or Vagal Nerve Stimulation (VNS). VNS consists in placing a small electrode at the neck, adding it to the Vagal Nerve. It is designed to prevent seizures by sending regular mild pulses of electricity to the brain through the vagal nerve. For Epilepsy Scotland, VNS is a viable treatment when the seizure couldn’t be controlled by with the AED. A treatment used in kids that suffer from epilepsy is the ketonic diet when controlling seizures with medication is hard. The Matthews Friend Organization describes ketonic diet as being a very low carbohydrate, a high-fat diet that changes the metabolism in the body from burning glucose for energy to burn fat to energy.

If you like to learn more about Epilepsy treatment, read Weed Designed for Epilepsy – CBD and the Charlotte’s Web Stain

What is a Seizure?

A seizure is often used to refer to a “convulsion”. A convulsion is when a person experiences uncontrollable shaking that is rapid and rhythmic, with the characteristic that the muscles relax and contract repeatedly. A seizure is the physical findings or changes in the behavior of a person after an episode of abnormal electrical activity in the brain, affecting how a person appears or acts for a short period of time. Some of the changes that might be produced by the electrical activity are a physical convulsion, disturbance thoughts, and minor physical signs. The electrical activity in the brain is caused by a series of complex chemical changes that take place in the nerve cells. Normally, there is a balance in cells that excite or inhibit other brain cells to send signals. During a seizure there might be too much or too little activity, causing an imbalance of cells. Seizure a symptoms of different brain disorders, rather than a disease itself. There are many different types of seizures, and the symptoms of this will vary depending on where in the brain the abnormal electrical activity occurs, the cause of the activity, age and the general health state of the person. Some seizures can be really disturbing, while other can hardly be noticed.

The Epilepsy Foundation describes seizures with four characteristics: unpredictable, episodic, brief and stereotypic. As they are unpredictable, it is important to be able to recognize when they are happening. EF gives a list of ten signs of a possible seizure:

  1. Odd feeling, often indescribable
  2. Unusual senses. Smell, taste or feelings
  3. Unusual experiences such as “out of body” sensations, feeling detach, body looks or feels different or people look unexpected familiar or strange.
  4. Feeling spaced or confused
  5. Daydreaming episodes
  6. Memory Lapses
  7. Headaches
  8. Jerking movement of extremities (legs or arms)
  9. Tingling or feeling of electricity in the body
  10. Unexpected loss control of urine or stool

A seizure can be caused by many different health conditions, anything that affects a person physically or emotionally can disturb the brain and trigger a seizure. Some of the most common reason for seizure are:

  • Alcohol withdraws
  • Brain infections as meningitis
  • Drug abuse or drug withdraw, especially with the use of narcotics such as cocaine and heroin
  • An electrolyte imbalance
  • Electric shock
  • Extremely high blood pressure
  • Fever
  • Head trauma

The exact cause of a seizure is hard to pinpoint, but most of them can be classified into two categories, provoked or unprovoked. A provoked seizure could be caused by a traumatic head injury. Some other reasons for a provoked seizure are birth trauma, alcohol or drugs, progressive brain disease and a stoke. Unprovoked seizures may be caused by different phenomena’s in the body, such as a cognitive defect or a chemical imbalance. Some reasons are genetic factors, congenital problems or conditions, fever/infection, Alzheimer’s disease and a fever or infection.

Seizures could also be group into focal (partial) seizures or Generalized seizures according to the parts of the brain involved in the episode. Focal seizures refer to seizures that only involves a specific part of the brain. They could be a simple partial seizure if there is no loss of consciences, or complex partial seizure if it involves loss of consciences. Simple partial seizures are characterized by three symptoms: Alteration of the senses, dizziness, and tingling and twitching limbs. Complex simple seizures characteristics are staring at blank, unresponsiveness, and performing repetitive movements. Many patients diagnosed with partial seizures might have had previous incidents that were not noticed or recognized as seizures. After a first seizure has occurred there are high possibilities of more seizures if the patient is not treated. Unfortunately in most cases of partial seizures, patient don’t visit a doctor until a more evident incident or convulsions has occurred.

A difference from the focal seizures, generalized seizures involves the whole brain. They are six types of generalized seizures according to the effects on the body. Absence seizure normally will cause a short memory loss and some repetitive movement such as blinking or smacking. Tonic seizure, that causes the muscles stiffness. Clonic seizures, which the main character is the uncontrolled movement of the face, neck, and arms. Tonic-clonic seizures also called grand mad seizures, that causes body stiffness, shaking, lost control of bowel movements, tongue biting and loss of consciousness. The type of seizure is caused by an abnormal electrical activity in the brain, being the main reason epilepsy. Tonic-Clonic seizures can also be trigger by other health problems as low blood sugar, high fever or a stoke. According to the Mayo Clinic, these seizures happen in two stages, the tonic phase that lasts between 10 to 20 seconds, where the muscles contracts causing the person to fall and the clonic phase that lasts up to two minutes where the person suffers from convulsions. After this stage, the person might remain unconscious for several minutes. Some of the consequences a person could suffer after a grand mad seizure is a period of confusion referred to postictal confusion, fatigue, headaches, and sleepiness. Many people who have had a grand mal seizure never have another one and don’t need treatment. People that have recurrent seizures may need treatment with daily anti-seizure medications to control and prevent future grand mal seizures.

The other types of generalized seizures are myoclonic seizures, characterized by the fast twitching of the extremities, arms and legs; and atonic seizures, in which the patient losses muscle control causing the body to fall down.

Seizures normally don’t cause any problem for people. Mostly only uncontrolled seizure could cause harm to the person. The consequences might vary according to the type of seizure, long length of it, when it occurs and if it escalates into an emergency. The most common physical injuries are bruises, cuts, burns, and falls. Serious problems as broken bones, concussions, head bleeding into the brain due to injuries or breathing problems are normally seeing in people with an uncontrolled seizure that experiences fall, long seizures or a series of repeated seizures. In patients suffering epilepsy have a significant risk of cognitive impairment and behavioral abnormalities. It appears that the reason for these consequences is the underlying neuropathology of epilepsy rather than the seizure itself. Some studies have shown that children’s immature brain might react differently to the long-term effects of seizure than mature brain.

If you like to learn more about seizures, read Preventing Sensory Overload with Cannabis Strain that Ground and Relax

Seizure treatments and medications

Currently, there is no cure for seizures. A variety of treatments are available to help to prevent them or help to avoid their triggers. There are three main treatments: Medication, Surgery, and diet.

Medication: A doctor might prescribe drugs or medicine normally called antiepileptics. The purpose of the medication is to alter or reduces the electrical activity in the brain. One of the many medications that can be prescribed is Phenytoin and Carbamazepine. To determine the medicine to use it is important to analyze the first seizure, according to Epilepsy Foundation. Determining the trigger of the first seizure will define the medicine and the treatment. If it determined that the seizure was the result of a head injury, infection or a reaction to a drug or some other drugs, and this can be resolved or can be avoided in the future the medication prescribed will be to address them avoiding the use of anti-seizure medicine.

Anti-seizure medication is normally started if the person has had more than one seizure or only one, but the tests suggest a risk of more seizures in the future. A study of when to treat the first seizure shows that starting seizure medication after the first seizure reduces the risk of more during the first two years. Doing this might reduce the risk in the first few years, but doesn’t affect the long-term risk of seizures. In children, anti-seizure medication could be prescribed if the child has had a single absence seizure and the EGG shows a typical pattern associated with a seizure type. The reason is that probably the child has experienced other starting events without being any witness to them. Seizure medication is normally not recommended under the following circumstances:

  • The Neurological examination is normal
  • The results of neuroimaging studies (CT and MR scans) are normal
  • The EGG is normal
  • Specific trigger has been identified and can be eliminated
  • No family history of epilepsy
  • The seizure happens while sleeping
  • Surgery: If medication is not helping to prevent seizures, surgery might be considered as an option. The surgery aims to remove the part of the brain where seizures begin. A requirement for an operating procedure is to have localized the exact place in the brain that provokes the seizures.
  • Diet: A ketogenic diet might be recommended is some patients. The diet is low in carbohydrates and proteins and high in fats. The propose of the diet is to change the body’s chemistry, therefore, resulting in a decreased of the frequency of the seizures.

Substances found in cannabis called Cannabinoids have been found to be effective in seizure treatment. Cannabinoids act on body cells called cannabinoid receptors to cause some effect. The two major ingredients include cannabinoids are Tetrahydrocannabinol (THC) and Cannabidiol (CBD). A neuronal balance between excitement and inhibitory communication is required for normal brain function. An imbalance can result in different problems such as convulsion or seizures. The brain’s endocannabinoid system provides protection against the convulsive activity, by regulating the central nervous system. Endocannabinoids, their receptors, synthetic and degradative enzymes, and uptake mechanisms make up the endocannabinoid system. The studies have shown that Cannabinoids found in cannabis mimics the endocannabinoid activity in reducing seizures and countering neurodegeneration.

Marijuana as a Seizure Treatment

Marijuana is a term that usually refers to the use of cannabis by smoking it. It is a slang term, usually with negative connotations but today more people use it as a reference to a type of medical cannabis treatment they use i.e. smoking joints or eating brownies with cannabis leaves added. Cannabinoids which we have talked about before in many of our articles are the molecular chemical compounds from the plant that provide all of the benefits and side effects. Side effects, in some cases depend on the purpose you wish to use the marijuana i.e. taking marijuana for acne could lower your heart rate as a side effect but this would be the main purpose of using it for those needing it as a blood pressure medication.

These cannabinoids interact with our body via our endocannabinoid system, an internal regulatory system responsible for keeping our body and brain and other systems (nervous system) in “check”. The two main effect causing cannabinoids you will find in marijuana is cannabidiol known as CBD and Tetrahydrocannabinol known as THC. Studies show that these cannabinoids react when heated up which is usually the case when you smoke marijuana or eat it (heat from the stomach/digestion).

THC is illegal in some states in America as are CBD oils from cannabis plants due to their potential to have trace elements of CBD. In the cannabis plant you usually find that CBD takes up the majority of the plant while THC takes up a smaller amount usually 5%. However, in some cases strains can be created so they included more THC than they naturally would so they can get a better return on investment.

THC is the cannabinoid which has neurological properties. In other words it can effect the brains. We mostly understand this property in the form of getting high. THC while it may be known for “getting high” it can also makes it users feel relaxed, hungry, sleepy and less aggressive. In some new studies a cannabinoid known a CBN (Cannabinol) is being further studied because of its similar positive effects as THC without the negative psychoactive effects of getting stoned. CBD is completely non-psychoactive and is usually praised, as we have mentioned before, for its anti-inflammatory properties. Although it is non-psychoactive it can have effects on the brain like reducing anxiety and other psychotic symptoms. CBD and THC used together are said to be the cause of the wonder cannabinoid CBN.

So how do these cannabinoids help us? Well the clue is their name, cannabinoid. We as humans (animals have them to) have molecules inside us called endocannabinoids. Cannabinoids from plants are known as phyto-cannabinoids. They are very similar in their make up and act just like our own endocannabinoids which is why they are so beneficial for us. However, the rate of their effectiveness is all down to our own endocannabinoid system (ECS) which is, as mentioned before, our regulatory system that keeps everything ticking over correctly. However, in some cases it doesn’t work so well and needs help. CBD stimulates the creation or reduction in cannabinoids that cause problems or provide help. While THC, and CBN for that matter, actually bind with our cannabinoid receptors to do pretty much the same thing.

Seizures affect the endocannabinoid system and the expression of the CB1 protein in the brain hippocampus. This increases the expression of CB1 receptors in the different regions of the hippocampus. Some studies have shown that this is the place for epilepsy control, but more study is needed to confirm it. Cannabis THC acts through the CB1 receptors, CBD acts along with THC, but it is unclear on how. CBD has low affinity to CB1 and CB2 receptors, their anticonvulsant properties are through cannabinoid receptor-independent mechanisms. THC and CBD together help to decrease convulsive activity. A study using CBD to THC in children up to age 18 years with hard to control epilepsy results shown the majority of participants reported seizure reduction. A low percentage of 7% stated that the seizures worsened.

It is important to note that even though marijuana is a plant, it is broken down in a person’s liver like many medicines. Additionally, as with any other medicament, cannabis has side effects. This will depend on how it is ingested. For example, if smoked, the risk factors associated with smoking apply to marijuana. Some of the side effects of using it to treat seizures are an increase/decrease in appetite, sleepiness, diarrhea, and fatigue. Most of this side effects were reported to be mild or moderate, that went away as the body got used to cannabis. Additionally, studies using CBD along with different medications shown different side effects, needing more studies in order to understand the drug to drug interaction.

Cannabis studies have been shown to be effective as an alternative treatment for different illness. It has several medicinal properties such as anti-seizure, anti-inflammatory, and relaxing. The use of cannabis as an al alternative treatment for epilepsy, as with any other medicament or treatment, is important to discuss it with a Doctor to determine if it is beneficial for each individual case before starting to use it.

If you like to learn more about marijuana medical properties, read People Use Marijuana for Anxiety and Promoting Calm

Editorial Staff
Editorial Staff
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