The following information is presented for educational purposes only.
Medical Marijuana Inc. provides this information to provide an understanding
of the potential applications of cannabidiol. Links to third party websites
do not constitute an endorsement of these organizations by Medical Marijuana
Inc. and none should be inferred.
Myoclonus is the quick, jerky contraction of an individual or group of
muscles that is often caused by an underlying health condition. Studies
suggest that cannabis lowers neuronal excitability and thus can potentially
reduce involuntary contractions.
Overview of Myoclonus
Myoclonus is a symptom characterized by a sudden, involuntary muscle jerk.
Myoclonic twitches can involve a single muscle or a group of muscles and can
feature a single twitch or contractions that happen a sequence and repeat at
various speeds. In some cases, myoclonus can cause a person to experience
persistent, shock-like contractions in a group of muscles. Severe cases can
severely limit the ability to eat, talk or walk.
The types of myoclonus can be classified as physiological, essential,
epileptic, or symptomatic (secondary). The most common form of myoclonus is
symptomatic, which occurs as a result of some underlying condition, such as
a neurological disorder, a reaction to a medication, prolonged oxygen
deprivation, kidney or liver failure, infection, head or spinal cord injury,
or a metabolic condition. It’s not uncommon for multiple sclerosis,
Parkinson’s disease, Alzheimer’s disease, or epileptic patients to develop
myoclonus. Healthy individuals experience physiological myoclonus, such as
hiccups or jerking suddenly just before falling asleep, and do not need to
be treated. Essential myoclonus occurs on its own, unrelated to an
underlying illness and typically without other symptoms. Epileptic myoclonus
occurs in association with an epileptic disorder.
According to the National Institute of Neurological Disorders and Stroke,
most myoclonus is caused by a disturbance of the central nervous system.
Scientists think that over-excitability of the motor pathways that control
movement is responsible for symptoms. Abnormalities or deficiencies in the
receptors of certain neurotransmitters may also be involved.
Treatment of myoclonus varies depending on its type and whether there is a
treatable underlying condition. In the cases where the underlying condition
can be fixed, such as changing the medication that causes jerking, myoclonus
symptoms can be eliminated. However, most underlying causes cannot be cured
or eliminated, so treatment efforts focus on easing myoclonus symptoms with
anticonvulsant or tranquilizer medications. Botox injections can be helpful
in treating myoclonus when it occurs in a single area. Surgery may be
necessary when myoclonus is caused by a tumor or lesion on the brain or
Findings: Effects of Cannabis on Myoclonus
Research looking into cannabis’ direct effect on myoclonus is lacking.
However, cannabis has been shown to have anticonvulsant and antiseizure
Multiple scientific reviews conclude that a major cannabinoid found in
cannabis, cannabidiol (CBD), has demonstrated the ability to reduce or even
(Blair, Deshpande & DeLorenzo, 2015) (Rosenberg, Tsien, Whalley & Devinsky,
2015) (Szaflarski & Bebin, 2014) (Devinsky, et al., 2014). In preclinical
trials, the administration of CBD and other cannabis cannabinoids have shown
to provide significant anticonvulsant effects in mice and rats (Turkansis,
et al., 1979) (Hill, et al., 2013). Most of the traditional medications used
to treat myoclonus are also used to treat epilepsy, which suggests that
cannabis, already demonstrating effective for epilepsy, may also prove
beneficial for myoclonus.
CBD’s ability to decrease or eliminate seizures is due to its effects on the
endocannabinoid system. CBD activates cannabinoid receptor 1 (CB1); The CB1
receptor then dampens neurotransmission and produces an overall reduction in
neuronal excitability (Wallace, Wiley, Martin & DeLorenzo, 2001) (Hoffman &
Frazier, 2013). This finding suggests that CBD may be able to combat
myoclonus caused by over excitability.
Cannabinoids have also proven beneficial for curtailing tics and tremors in
movement disorders like Parkinson’s disease and Huntington’s disease (Kluger,
Triolo, Jones & Jankovic, 2015) (Fernandez-Ruiz, 2009) (Fernandez-Ruiz &
Gonzales, 2005). Researchers suggest that cannabinoids may help alleviate
involuntary motor symptoms because both CB1 and CB2 receptors, which
cannabinoids act upon, have been found to be located in the basal ganglia
and cerebellum. These are areas of the brain that control movement
(Fernandez-Ruiz & Gonzales, 2005).
States That Have Approved Medical Marijuana for Myoclonus
Currently, only the state of Illinois has
approved medical marijuana specifically for the treatment of myoclonus.
However, in Washington
any condition can be approved for medical marijuana as long as a DC-licensed
physician recommends the treatment. In addition, a number of other states
will consider allowing medical marijuana to be used for the treatment of
myoclonus with the recommendation from a physician. These states include: California (any
debilitating illness where the medical use of marijuana has been recommended
by a physician), Connecticut (other
medical conditions may be approved by the Department of Consumer
Protection), Massachusetts (other
conditions as determined in writing by a qualifying patient’s physician), Nevada (other
conditions subject to approval), Oregon (other
conditions subject to approval), Rhode
conditions subject to approval), and Washington (any
“terminal or debilitating condition”).
Twenty-five states have approved medical marijuana specifically to treat
epilepsy. These states include: Alabama (debilitating
epileptic conditions), Connecticut, Delaware (intractable
epilepsy), Florida, 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
Several states have approved medical marijuana to treat seizures or seizure
disorders. These states include: Alaska, Arizona, Arkansas, California, Colorado, Delaware, Hawaii, Louisiana, Maryland, Michigan, Minnesota, Montana, Nevada, New
Dakota, Ohio, Oregon, Pennsylvania (intractable
Island, Tennessee (intractable
seizures), Vermont and Washington.
Sixteen states have approved medical marijuana for the treatment of spasms.
These states include: Arizona, Arkansas, California, Colorado, Delaware, Florida, Hawaii, Maryland, Michigan, Minnesota, Montana, Nevada, New
Hampshire, Oregon, Rhode
Island and Washington.
Recent Studies on Cannabis’ Effect on Myoclonus
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, R.E., 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,
Fernandez-Ruiz, J. (2009, April). The endocannabinoid system as a target for
the treatment of motor dysfunction. British
Journal of Pharmacology,
Fernandez-Ruiz, J., and Gonzales, S. (2005). Cannabinoid control of motor
function at the basal ganglia.
Handbook of Experimental Pharmacology,
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,
Hoffman, M.E., and Frazier, C.J. (2013, June). Marijuana, endocannabinoids,
and epilepsy: potential and challenges for improved therapeutic
Myoclonus. (2012, December 20). Mayo
Retrieved from http://www.mayoclinic.org/diseases-conditions/myoclonus/basics/definition/con-20027364.
Myoclonus Fact Sheet. (2015, February 23). National
Institute of Neurological Disorders and Stroke.
Retrieved from http://www.ninds.nih.gov/disorders/myoclonus/detail_myoclonus.htm.
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 epilepsy–from receptors to clinical response. Epilepsy
Turkanis, S.A., Smiley, K.A., Borys, H.K., Olsen, D.M., and Karler, R.
(1979, August). An electrophysiological analysis of the anticonvulsant
action of cannabidiol on limbic seizures in conscious rats. Epilepsia,
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,
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