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

• Published in: Epilepsy & behavior 2018-04, Vol.81, p.79-85
• Main Authors: Neubauer, David, Perković Benedik, Mirjana, Osredkar, Damjan
• Format: Article
• Language: English
• Subjects: Adolescent; Anticonvulsants - therapeutic use; Antiepileptic drugs; Cannabidiol; Cannabidiol - therapeutic use; Child; Child, Preschool; Drug Resistant Epilepsy - drug therapy; Electroencephalography; Epilepsy; Female; Humans; Male; Pharmacoresistant; Refractory; Seizures - drug therapy; Slovenia
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2018.02.009

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. 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. 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. 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. •Refractory epilepsies in children present a major burden for patients and their families.•CBD was found to be an effective add-on therapy in refractory childhood epilepsies for reducing seizure burden.•CBD therapy had other beneficial side effects along with minor negative side effects.