Abstract
Objective: To evaluate the efficacy of cannabidiol in treatment of pediatric seizures based upon published data.
Background: Medication-resistant epilepsy poses a challenge in the field of pediatric neurology, and is associated with poor clinical outcomes, decreased quality of life, high healthcare costs. Patients who continue to have uncontrolled seizures despite treatment with multiple antiepileptic drugs (AED’s) and other interventions such as the ketogenic diet or vagal nerve stimulator are left with few options. The changing popular and political climate has facilitated growing interest and research in the antiepileptic properties of cannabinoids, especially those with a high content of cannabidiol (CBD). However, limited data exists regarding the use of cannabinoids in pediatric epilepsy.
Design/Methods: We searched Pubmed to perform a systematic review in accordance with the PRISMA statement. We included studies in children with epilepsy in which CBD or other cannabinoid products were used and which evaluated efficacy. Outcomes were measured by percent seizure reduction (no change, 0–50%, 50–100%, 100% reduction in seizure activity). Side effects were described.
Results: Of 44 studies, 9 met all inclusion/exclusion criteria, and were included in the final analysis. The pooled sample size for CBD was 541 patients. In all patients, CBD was added to their existing AED regimen. Of total patients, 15/541 (2.8%) experienced no change, 260/541 (48.1%) experienced 0–50% reduction, 211/541 (39%) experienced 50–100% reduction, and 44/541 (7.4%) experienced complete reduction in seizure frequency. 11/541 (2%) reported worsening seizures. The most common side effects were drowsiness and changes in appetite. Positive cognitive effects included improved sleep, alertness, and behavior.
Conclusions: CBD oil reduces seizure frequency in a significant number of pediatric patients with intractable epilepsy on multiple AEDs. Larger, randomized, double-blinded studies would be needed with controlled doses of CBD and prolonged follow up to accurately assess CBD utility in the future.
Disclosure: Dr. Kaur has nothing to disclose. Dr. Andriola has received personal compensation for activities with UCB as a speaker. Dr. Manganas has nothing to disclose.
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