Epilepsy is a persistent (chronic) condition of the brain. It involves unpredictable abnormal electrical discharges or misfirings of brain cells (neurons). This misfiring in the brain can cause episodes of bodily convulsions, loss of coordination, loss of consciousness or altered sensory states. These episodes are commonly called seizures. People with epilepsy have persistent and recurring seizures. One may be born with epilepsy, or may acquire it as a result of disease or injury.
Epileptic seizure are often classified as partial seizures or generalized seizures. Partial seizures are more common and start in an isolated part of the brain. Partial seizures can be described as either simple or complex. When a simple partial seizure occurs, a person retains consciousness. The person with epilepsy may experience uncontrollable twitching or stiffening in a limb. There may be a tingling sensation, a change in consciousness or an odd smell without a source. The subjective sensations that may warn of an impending event are called an “aura”.
Complex partial seizures cause an impairment of consciousness. During this type of seizure, a person may act confused, aimless, fidgety, emotional or disturbed. They are likely to have no memory of the event after it is over. A simple partial seizure may progress to a complex partial seizure and then become a generalized seizure as the abnormal electrical discharge spreads to the entire brain.
Generalized seizures involve abnormal discharges or misfirings in all regions of the brain and result in impairment of consciousness. Behavior during generalized seizures may range from a blank stare with little or no movement (petit mal or “absence” seizures) to dramatic bodily convulsions (grand mal seizures). During these convulsions, the patient may have difficulty breathing and turn blue. They may also bite their tongue and may lose control of urine or stool. When they regain consciousness, they do not remember the event and are very sleepy.
Epilepsy is conventionally treated with a class of drugs called anticonvulsants. Standard drugs in this class include carbamazepine (Tegretol), phenytion (Dilantin), primidone Mysoline, valproic acid (Depakote), clonazepam (Klonopin), ethosuximide (Zarontin) and phenobarbital. Newer drugs are coming on to the market but there is less experience using them. Doctors prescribe anticonvulsants or antiepileptic drugs according to the types of seizures patients experience and how well the patient can tolerate the drug. Many patients have a poor response to these drugs even when taken in combination.
In addition to problems with effectiveness, there can be serious side effects resulting from the use of anticonvulsants. While these side effects do not always occur, they can include nausea, headaches, loss of hair, swelling of gum tissue, impotence, depression, poor coordination (ataxia), liver failure, depressed blood counts and even psychosis.
Some people with grand mal seizures say they can prevent their seizures entirely by smoking marijuana. Others, who suffer complex partial seizures, report that marijuana also curbs their symptoms and prevents loss of consciousness. Marijuana is not considered useful for treating petit mal or absence seizures and may even worsen them.
Some patients find that marijuana works in conjunction with other drugs they are taking. Others find that marijuana works best for them when it is used without other drugs. Either way, these epileptic patients have made marijuana a necessary part of their medical treatment.
People using marijuana to control epilepsy should be aware that withdrawal from any medication that controls seizures may leave you more susceptible to the seizures. Marijuana is no exception. Patients with epilepsy are advised to exercise caution when using oral THC because there is not sufficient knowledge about the convulsive or anti-convulsive properties of the single compound.
The anticonvulsant properties of marijuana may be the oldest of its known medical benefits. Marijuana was used as a medicine for epilepsy by ancient societies in China, Africa, India, Greece and Rome. Written testimonies of its usefulness, such as the one by Dr. W.B. O’Shaughnessy appeared in Western scientific journals in the 19th century. Dr. O’Shaughnessy’s classic account of the uses of marijuana in India was published by the Ohio Medical Society in 1860.
There is some contradictory data about marijuana having both convulsive and anticonvulsive effects. In a few cases, patients have reported experiencing seizures after taking extremely high doses of oral THC. Site the one study most common… It is for this reason that Marinol is not thought to be safe or effective for controlling epilepsy.
Throughout the mid 1970’s and early 1980’s, Dr. Paul Consroe of the University of Arizona, conducted a number of studies using both THC and CBD on animals. He found that while high doses (near lethal) of THC can trigger convulsions in seizure susceptible animals, the administration of cannabidiol (CBD) in similar or higher does not cause convulsions. His studies concluded that CBD may have powerful anticonvulsant properties which counteract the muscle-exciting effects of THC when both compounds are delivered to the body in marijuana. However, small studies in which cannabidiol alone was administered did not yield consistently favorable results. This may point to the fact that the safest and most effective way to treat epilepsy with marijuana is to use all of its compounds together by smoking the plant rather than ingesting its separate ingredients.
In 1975 a report, published in the Journal of the American Medical Association, marijuana smoking controlled the seizures in one 24-year-old patient when combined with conventional anit-epileptic medicine. The subject had experienced incomplete control of his seizures on a regimen of the anticonvulsant drugs, phenobarbital and phenytoin (Dilantin), and complained of grand mal seizure attacks as often as every two months. At the age of 22, he began smoking two to five marijuana cigarettes a day, in conjunction with his regular anticonvulsant medication. At this point, his doctors observed that his epileptic seizures completely stopped.
In 1980, a study appeared in Pharmacology involving 16 patients with grand mal epilepsy who had not responded well to treatment with standard antiepileptic drugs. Each patient was given 200 to 300 milligrams of cannabidiol or a placebo in addition to their antiepileptic drugs. Of the eight patients who received cannabidiol, three experienced complete improvement, two showed partial improvement, two showed minor improvement and one was unchanged. The only adverse side effect was mild sedation. Of the eight placebo patients, only one showed substantial improvement. The other seven patients showed little or no improvement. The report concluded that cannabidiol combined with standard antiepileptic drugs may be effective for controlling epileptic seizures in some patients.