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.
West syndrome is a type of severe pediatric epilepsy that affects one baby
out of a few thousand in the US1.
Studies have shown CBD-enriched cannabis is effective at significantly
reducing seizure frequency, even potentially offering complete seizure
freedom, in children with West’s syndrome and other types of epilepsy.
Overview of West’s Syndrome (Infantile Spasms)
West syndrome, or infantile spasms, is a pediatric epilepsy syndrome
that is characterized by the baby’s experiencing involuntary stiffening.
Named after Dr. William James West who first described the syndrome in the
1840s, West’s syndrome is considered an age specific epilepsy, typically
developing between three and eight months of age. Nearly all cases begin
before an infant turns one and will stop between the ages of two to four
Commonly, the baby’s arms will fling out and the knees will pull up to the
chest as the torso bends forward, in what appears to be a “jackknife.” In
some cases, however, the baby’s head can throw back as the body and legs
stiffen straight out.
Seizures last a second or two, but typically occur shortly after one another
in a series. With each attack, the spasms can repeat from 10 to 20 or more
The spasms most commonly occur upon waking. Infants may cry during or
immediately after experiencing a series of spasms. When the syndrome first
develops, attacks typically are infrequent and do not occur in a series,
which often causes an incorrect initial diagnosis of colic.
According to the Epilepsy Foundation, about two thirds of babies with West
syndrome have some known cause for the seizures.
Conditions, like malformations in the brain, a lack of oxygen to the brain,
problems with a gene, issues with body metabolism, brain infections, or
brain injuries may occur before the seizures first develop. In the other
third of cases, there is no known condition or injury that causes the
West syndrome can limit the normal development of baby’s and cause them to
lose the ability of rolling over, sitting, or babbling. Most children with
infantile spasms experience intellectual disabilities later in life and some
Most children with West syndrome, even if the spasms cease, will eventually
develop other kinds of epilepsy like Lennox-Gastaut
Treating the seizures associated with West syndrome early and appropriately
is important for limiting their damage. Traditional treatments are steroids
or anti-seizure medications. In some cases, epilepsy surgery to address
brain malformations may be necessary.
Findings: Effects of Cannabis on West Syndrome
Several studies have found that cannabidiol (CBD), a major cannabinoid found
in cannabis, can reduce or even eliminate seizures[4,5,11,12].
These results are also found in severe pediatric epilepsies like West
syndrome, Doose syndrome, and Lennox-Gastaut syndrome. In one
questionnaire study, CBD-enriched cannabis reduced seizure frequency in
children with West syndrome and Lennox-Gastaut syndrome by 85 percent, while
14 percent experienced complete seizure freedom. They also reported an
improvement in sleep (53 percent), alertness (71 percent), and mood (63
Another survey found that 85 percent of parents reported that cannabis
treatment caused a reduction in their child’s seizure frequency. Out of
those parents, 11 percent of them responded that their child has reached
complete seizure freedom, while 42 percent reported a greater than 80
percent reduction in seizure frequency. The parents also reported an
increase in alertness, better mood, and improved sleep.
One case report inspecting a young epileptic girl found that cannabis
treatments reduced the child’s 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 antiepileptic drugs she had been
CBD’s capability to reduce or eliminate seizures is due to its activation of
the cannabinoid receptor 1 (CB1).
When stimulated, the CB1 receptor
dampens neurotransmission and produces an overall reduction in neuronal
Traditional medicines used to treat pediatric epilepsy often come with a
number of adverse side effects. Preclinical and preliminary human studies
have reported that cannabis treatments produce fewer adverse effects that
other antiepileptic drugs.
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.
States That Have Approved Medical Marijuana for West Syndrome
While no states have approved medical marijuana specifically for the
treatment of West syndrome, 20 states have approved medical marijuana
specifically to treat epilepsy. These states include: Alabama (debilitating
epileptic conditions), Connecticut, Delaware (intractable
epilepsy), Georgia (seizure
disorder), Iowa (intractable
epilepsy), Maine, Mississippi (intractable
epilepsy), Missouri (intractable
epilepsy), Oklahoma (pediatric
syndrome, Lennox-Gastaut syndrome, Refractory epilepsy), Texas (intractable
epilepsy), Utah (intractable
epilepsy), Virginia (intractable
epilepsy), Wisconsin (seizure
disorders), and Wyoming (intractable
In addition, 22 states approve medical marijuana to treat seizures. 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.
Recent Studies on Cannabis’ Effect on West Syndrome
CBD-enriched cannabis reduced seizure frequency in 84% of children with
West syndrome (infantile spasms) and Lennox-Gastaut syndrome, 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.(http://www.ncbi.nlm.nih.gov/pubmed/24237632)
CBD-enriched cannabis reduced frequency of seizures in 85% of children,
while 14% reported complete seizure freedom. Children also experienced
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.
1. Infantile Spasms / West’s Syndrome. (2015, December). Epilepsy
Foundation. Retrieved from http://www.epilepsy.com/learn/types-epilepsy-syndromes/infantile-spasms-wests-syndrome.
2. Infantile Spasm (West Syndrome). (2014, October 16). Medscape.
Retrieved from http://emedicine.medscape.com/article/1176431-overview.
3. West syndrome (infantile spasms). (n.d.). Epilepsy
Action. Retrieved from
4. 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, 16(13), 1911-4.
5. 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,
6. 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, 40(2), 135-43.
7. Hoffman, M.E., and Frazier, C.J. (2013, June). Marijuana,
endocannabinoids, and epilepsy: potential and challenges for improved
therapeutic intervention. Experimental
Neurology, 244, 43-50.
8. 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
& Behavior, 47, 138-41.
9. Maa, E. and Figi, P. (2014, June). The case for medical marijuana in
10. Porter, B.E., and Jacobson, C. (2013, December). Report of a parent
survey of cannabidiol-enriched cannabis use in pediatric treatment-resistant
& Behavior, 29(3), 574-7.
11. 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.
12. Szaflarski, J.P., and Bebin, E.M. (2014, December). Cannabis,
cannabidiol, and epilepsy–from receptors to clinical response. Epilepsy
& Behavior, 41, 277-82.
13. 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, 428(1), 51-7.
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