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Dravet syndrome is a type of severe epilepsy that develops during the first
year of childhood and is characterized by frequent febrile seizures. Studies
have shown marijuana has the capability of reducing, and in some cases
Overview of Dravet Syndrome
Dravet syndrome, which is also referred to as severe myoclonic epilepsy of
infancy (SMEI), is a severe form of epilepsy that typically develops during
the first year of life. The high frequency of seizures caused by the
syndrome commonly causes children to experience difficulty developing
language and motor skills. In addition, they often experience hyperactivity
and have problems relating to others.
Dravet syndrome typically causes febrile seizures, which are fever-related
(associated with a high body temperature but without any attributing health
issue). Seizures can be triggered by slight body temperature changes,
flashing lights, emotional stress or excitement. In addition, myoclonic
seizures, characterized by involuntary muscle spasms, and status epilepticus,
a state of continuous seizure that lasts longer than 30 minutes and requires
emergency care, can arise.
According to the National Institute of Neurological Disorders and Stroke, 30
to 80% of Dravet syndrome cases are caused by defects in the SCN1A gene,
which are essential for the brain cells to properly function.
There is no cure for Dravet syndrome, but in some cases medications can help
control seizures. In addition, adjusting the diet so that itís high in fats
and low in carbohydrates may be beneficial. While itís a lifelong condition,
itís not uncommon for children with Dravet syndrome to experience
improvements and better cognitive function with age.
Findings: Effects of Cannabis on Dravet Syndrome
One of the major cannabinoids found in cannabis, cannabidiol (CBD), has been
determined to be a well-tolerated therapeutic treatment that can reduce or
even eliminate seizures in a variety of childhood epilepsy disorders (Blair,
Deshpande & DeLorenzo, 2015) (Rosenberg, Tsien, Whalley & Devinsky, 2015) (Szaflarski
& Bebin, 2014) (Devinsky, et al., 2014). Preclinical trials have found that
cannabis causes significant anticonvulsant effects in mice and rats (Hill,
et al., 2013) (Hill, Williams, Whalley & Stephens, 2012).
CBD is able to reduce or eliminate seizures because it activates the
cannabinoid receptor 1 (CB1) of the bodyís endocannabinoid system. The CB1
receptor, once activated, inhibits the release of a particular
neurotransmitter and reduces overall neuronal excitability, thus silencing
the triggers of seizures (Wallace, Wiley, Martin & DeLorenzo, 2001) (Hoffman
& Frazier, 2013).
One case report analyzing a young girl with Dravet syndrome found that
medical marijuana brought the childís seizure frequency from nearly 50
convulsive seizures per day to 2-3 nocturnal convulsions per month. In
addition, the child was able to wean from the additional anti-epileptic
drugs she had been taking (Maa & Figi, 2014).
Double-blind randomized, placebo-controlled studies are currently lacking,
but early research suggests that cannabis may be effective in treating a
variety of of severe pediatric epilepsy disorders like Dravet syndrome. In
one questionnaire study, 84% of parents reported a reduction in their
childís seizure frequency following cannabis treatment. Out of those
parents, 11% of them responded that their child has reached complete seizure
freedom, while 42% reported a greater than 80% reduction in seizure
frequency. The parents also reported additional beneficial effects, such as
increased alertness, better mood and improved sleep (Porter & Jacobson,
2013). Another similar survey found that CBD-enriched cannabis brought about
a reduction in seizure frequency in 85% of epileptic children, while 14%
experienced complete seizure freedom. The children also reported an
improvement in sleep (53%), alertness (71%), and mood (63%) while being
treated with CBD (Hussain, et al., 2015).
Traditional medicines used to treat epilepsy are not just ineffective for
most; they often come with a number of adverse side effects. Cannabinoids
found in cannabis, however, have shown to produce anticonvulsant effects in
preclinical and preliminary human studies while producing fewer adverse
effects that other antiepileptic drugs (dos Santos, et al., 2015). A
questionnaire study found that parents tried an average of 12 different
antiepileptic drugs, due to ineffectiveness or unacceptable side effects,
before finding gentle effectiveness with cannabis (Porter & Jacobson, 2013).
States That Have Approved Medical Marijuana for Dravet Syndrome
Currently, just South
approved medical marijuana specifically for the treatment of Dravet
syndrome. However, 23 states have approved medical marijuana specifically to
treat epilepsy and other seizure disorders. These states include: Alabama (debilitating
epileptic conditions), Connecticut, Delaware (intractable
epilepsy), Georgia (seizure
disorder), Iowa (intractable
epilepsy), Louisiana, Maine, Mississippi (intractable
epilepsy), Missouri (intractable
Jersey (seizure disorders), New
Dakota, Ohio, Oklahoma (pediatric
epilepsy), Pennsylvania, South
Carolina (Dravet syndrome,
Lennox-Gastaut syndrome, Refractory epilepsy), Texas (intractable
epilepsy), Utah (intractable
epilepsy), Virginia (intractable
epilepsy), Wisconsin (seizure
disorders), and Wyoming (intractable
In addition, several states approve medical marijuana to specifically treat
seizures. These states include: Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Hawaii, Louisiana, Maryland, Michigan, Minnesota, Montana, Nevada, New
Dakota, Ohio, Oregon, Pennsylvania (intractable
Island, Tennessee (intractable
seizures), Vermont and Washington.
The state of Massachusetts will
consider allowing medical marijuana to be used for the treatment of Dravet
syndrome if itís determined in writing by a qualifying patientís physician.
D.C., any condition can be approved for medical marijuana as long as a
DC-licensed physician recommends the treatment.
Recent Studies on Cannabisí Effect on Dravet Syndrome
CBD-enriched cannabis reduced seizure frequency in 85% of children and
14% reported complete seizure freedom. Children also saw improvements in
sleep (53%), alertness (71%), and mood (63%).
Perceived efficacy of cannabidiol-enriched cannabis extracts for
treatment of pediatric epilepsy: A potential role for infantile spasms
and Lennox-Gastaut syndrome. (http://www.ncbi.nlm.nih.gov/pubmed/25935511)
Cannabis reduced seizure frequency in 84% of children, while 11%
reported complete seizure freedom. Additional beneficial effects
included increased alertness, better mood, and improved sleep.
Report of a parent survey of cannabidiol-enriched cannabis use in
pediatric treatment-resistant epilepsy.
Cannabis provided significant anticonvulsant effects in mice and rats.
Cannabidivarin-rich cannabis extracts are anticonvulsant in mouse and
rat via a CB1 receptor-independent mechanism
Blair, RE., Deshpande, L.S., and DeLorenzo, R.J. (2015, September).
Cannabinoids: is there a potential treatment role in epilepsy? Expert
Opinion on Pharmacology,
Devinsky, O., Cilio, M.R., Cross, H., Fernandez-Ruiz, J., French, J., Hill,
C., Katz, R., Di Marzo, V., Jutras-Aswad, D., Notcutt, W.G.,
Martinez-Orgado, J., Robson, P.J., Rohrback, B.G., Thiele, E., Whalley, B.,
and Friedman, D. (2014, June). Cannabidiol: pharmacology and potential
therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia,
dos Santos, R.G., Hallak, J.E., Leite, J.P., Zuardi, A.W., and Crippa, J.A.
(2015, April). Phytocannabinoids and epilepsy. Journal
of Clinical Pharmacology and Therapeutics,
Friedman, D. and Devinsky, O. (2015, September 10). Cannabinoids in the
Treatment of Epilepsy. The
New England Journal of Medicine,
Hill, T.D., Cascio, M.G., Romano, B., Duncan, M., Pertwee, R.G., Williams,
C.M., Whalley, B.J., and Hill, A.J. (2013, October). Cannabidivarin-rich
cannabis extracts are anticonvulsant in mouse and rat via a CB1
receptor-independent mechanism. British
Journal of Pharmacology,
Hill, A.J., Williams, C.M., Whalley, B.J., and Stephens, G.J. (2012,
January). Phytocannabinoids as novel therapeutic agents in CNS disorders. Pharmacology
Hoffman, M.E. and Frazier, C.J. (2013, June). Marijuana, endocannabinoids,
and epilepsy: potential and challenges for improved therapeutic
Hussain, S.A., Zhou, R., Jacobson, C., Weng, J., Cheng, E., Lay, J., Hung,
P., Lerner, J.T., and Sankar, R. (2015, June). Perceived efficacy of
cannabidiol-enriched cannabis extracts for treatment of pediatric epilepsy:
A potential role for infantile spasms and Lennox-Gastaut syndrome. Epilepsy
Maa, E. and Figi, P. (2014, June). The case for medical marijuana in
NINDS Dravet Syndrome Information Page. (2001, September 29). National
Institute of Neurological Disorders and Stroke.
Retrieved from http://www.ninds.nih.gov/disorders/dravet_syndrome/dravet_syndrome.htm.
Porter, B.E., and Jacobson, C. (2013, December). Report of a parent survey
of cannabidiol-enriched cannabis use in pediatric treatment-resistant
Rosenberg, E.C., Tsien, R.W., Whalley, B.J., and Devinsky, O. (2015, August
18). Cannabinoids and Epilepsy. Neurotherapeutics,
Epub ahead of print. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26282273.
Szaflarski, J.P., and Bebin, E.M. (2014, December). Cannabis, cannabidiol,
and epilepsyĖfrom receptors to clinical response. Epilepsy
Wallace, M.J., Wiley, J.L., Martin, B.R., and DeLorenzo, R.J. (2001,
September 28). Assessment of the role of CB1 receptors in cannabinoid
anticonvulsant effects. European
Journal of Pharmacology,
What is Dravet syndrome? (2014, March). Epilepsy
Retrieved from http://www.epilepsy.com/learn/types-epilepsy-syndromes/dravet-syndrome.
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