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Medical Marijuana's Role in Managing Seizures

A seizure is primarily characterized by convulsions, or the uncontrollable twitching or jerking of the arms and legs. Seizures also cause temporary confusion, loss of consciousness, and even cognitive or emotional disturbances like loss of awareness or reduced awareness, fear, and deja vu. These symptoms range from mild to severe, and are caused by any amount of sudden disruptions or “misfires” in brain as its neurons send and receive electrical impulses.

Seizures are usually associated with epilepsy, although there are several medical conditions that can cause seizures, such as cerebral palsy, hyperglycemia and hypoglycemia, meningitis, stroke, and toxoplasmosis. Even withdrawal syndromes from various addictive substances like alcohol can cause some form of seizures. In fact, it is only when you have two or more types of seizures or experience recurrent episodes of seizures that you are considered to have epilepsy.

Types of Seizures

Seizures are classified by where they originate and how they form in the brain: focal seizures that are result of disrupted electrical activities in only one area of the brain, and generalized seizures that involve most or all areas of the brain. Either type of seizure may last anywhere from 30 seconds to two minutes; should an episode last for more than five minutes, it is already considered a medical emergency.

Focal seizures are further classified into two types. Those that occur with loss of consciousness or impaired awareness, and those that do not. The former may be indicated by staring absently into space and not being able to respond normally to the environment; patients may also not be able to perform actions like chewing, swallowing, and other small repetitive movements. Meanwhile, the latter type of focal seizure does not cause loss of consciousness, although it may result in a slight alteration in the way the patient sees, smells, feels, hears, of tastes things, apart from the involuntary jerking of the extremities. It may also cause sensory symptoms like tingling of the fingertips and dizziness. This is why the symptoms of focal seizures may be confused with those of other neurological illnesses like migraine and narcolepsy.

On the other hand, generalized seizures are usually classified into six types. Absence seizures, which used to be called petit mal seizures, often happen to children, with symptoms like staring into space or subtle, repetitive body movements like blinking and lip smacking. The patient may also suffer from a brief loss of awareness. Tonic seizures cause muscle stiffness in the back, arms, and legs; closely related to this are atonic seizures, which are also called drop seizures due to its tendency to cause patients to collapse or fall down from loss of muscle control. Clonic seizures are usually isolated to the upper body, especially the neck, face, and arms; this condition is usually indicated by repeated and/or rhythmic jerking of muscles. Meanwhile, myoclonic seizures are focused on the arms and legs, with brief and abrupt twitches. Finally, tonic-clonic seizures, which used to be known as grand mal seizures, can cause loss of consciousness, stiffening and shaking of the entire body, and even loss of bladder control. This type of seizure is the one that is often portrayed in the media, which perhaps gives a rather skewed image of epilepsy and seizures in general.

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Managing and Treating Seizures

If you’ve only had one seizure before, your doctor will most likely not issue any treatment just yet since it may be an isolated incident. However, if you’ve already experienced more than one, then the goal is to find the type of treatment that stops or minimizes the seizures with none or the least number of side effects.   

Anti-seizure medications are the most popular way to manage this condition. Sometimes, doctors prescribe more than one, as the person’s age, frequency of seizures, and current medications, among others, may affect the efficacy of the anti-seizure drugs. Other treatments can include surgery, where the doctors remove the problematic area in the brain where seizures originate. This is the optimal choice for patients who have focal seizures that always begin in the exact spot. Stimulation therapies, which usually involve the implantation of devices that send electrical signals of their own to stop or correct your brain’s own malfunctioning signals, are also viable solutions that may eliminate the need or reduce the dosage of medications.

Alternative treatments include dietary therapy, which focuses on high-fat, low-carbohydrate diets — also known as ketogenic diets — which help improve seizure control. Other variations like a modified Atkins diet are less restrictive, and are therefore more enjoyable, although they may be less effective. With increasing bodies of research supporting its effectivity, medical marijuana is also increasingly used as an alternative means to manage seizures, especially in patients with epilepsy.

Medical Marijuana as a Treatment for Seizures

The use of medical marijuana, particularly the cannabinoid cannabidiol (CBD), to treat and manage seizures began as early as 1973, when a group of Brazilian scientists found that CBD reduced and sometimes even completely prevented epileptic convulsions in animals. A year later, more researchers from Brazil discovered that CBD also reduces feelings of anxiety, another symptom of epilepsy.

By the 1990s, more and more researchers worked to understand the body’s own endocannabinoid system (ECS), which respond heavily to the cannabinoids found in marijuana. Indeed, some studies worked to unravel how the ECS and its CB1 receptors react with cannabinoids to improve synaptic transmission, which is a critical aspect in understanding why and how seizures happen.

Since then, more and more studies have delved into the potential of CBD for managing seizures, especially in children since they and older adults have the highest incidence rates of epilepsy. But apart from the cannabinoid’s capability to reduce or prevent the seizures caused by epilepsy, some scientists have also delved into the neuroprotective potential of CBD and other cannabinoids, because the health and regeneration of nerve cells is crucial in managing seizures and similar neurological conditions.

More recently, in 2013, the case of Charlotte Figi brought new light to the potential of medical marijuana to treat epilepsy in children. Figi, who has Dravet syndrome — a rare and highly debilitating form of epilepsy — and has suffered from seizures since she was only three months old, has shown significant progress with the disease. She has much fewer and more manageable attacks since taking a dose of CBD oil, pressed from just 2 ounces of the R4 strain, when she was 5 years old. Indeed, the high-CBD strain of cannabis called Charlotte’s Web was specifically developed for and named after Charlotte.

In 2016, researchers from New York University Langone Medical Center, explored the potential of CBD in treating patients who have treatment-resistant forms of epilepsy, just like Charlotte and one third of all people who have epilepsy. The results were promising: motor seizures were reduced at a rate similar to medications currently used to treat epileptic seizures, with a median efficacy rate of 36.5 percent. The adverse effects, which 79 percent of the participants reported to have experienced, include sleepiness and diarrhea, although these are already known side-effects of both medical and recreational marijuana.

A group of three researchers also reviewed the current status of artisanal cannabis as a treatment for epilepsy and its symptoms. Published just last May 2017, the study followed the progress of 272 combined patients from Washington and California and found that 17 percent of patients experienced up to 25 percent reduction in seizures, 18 percent experienced up to 50 percent reduction in seizures, and 28 percent experienced anywhere from 76 to 99 percent reduction in seizures. Only 14 percent or a total of 37 patients found cannabis to ineffective at reducing their seizures.

The same study also found that the adverse side-effects of using the herb were rather mild, and beneficial side-effects such as alertness were also experienced by the participants. In addition, the researchers claimed that artisanal cannabis should be considered for patients with treatment-resistant epilepsy like Dravet syndrome and Lennox-Gastaut syndrome. They also said that a combination of cannabinoids, not just CBD, may prove to be more effective. Potential cannabinoids to improve seizure reduction include tetrahydrocannabinol (THC), tetrahydrocannabinolic acid (THCA), and cannabielsoin (CBE).

The authors also noted that the anti-convulsive action of cannabis can take effect even in doses as low as 0.05 mg of CBD per kilogram per day — an amount that is shown to improve cognition in patients. On the other hand, 1 mg of THC per kilogram per day was found to prevent the occurrence of seizures for up to four days, while 2 mg of THCA per kilogram per day reduced up to 90 percent of seizures. Furthermore, the authors also found that some terpenes, among them linalool, also deliver and sometimes even enhance the anticonvulsant properties of these cannabinoids.

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Cannabis Strains for Managing Seizures

Epilepsy and other seizure disorders are among the most well-documented cases with regards to the prescription and usage of medical marijuana. And while the effects may be achieved no matter the preparation, the most effective cannabis product (based on exact dosages) is CBD oil, taken directly or in the form of capsules or mixed into food.

Whichever is your preferred method or whatever is your doctor’s recommendation, however, here are some strains that you might want to try or inquire about.

  1. Charlotte’s Web. This strain is, of course, the most popular and most obvious choice. Specifically cultivated by The Stanley Brothers, famed cannabis breeders in Colorado, for Charlotte Figi, this high-CBD strain is a potent medical marijuana strain that is used to treat seizures and a host of other medical conditions. While it has less than 0.3% THC content, one of the most common side-effects of this powerful strain is dizziness so exercise caution in using this, especially if you are trying it for the first time.
  2. Purple Urkle. Despite it being an indica, Purple Urkle actually has a high CBD content and in fact has lower THC content compared to its cousin, Granddaddy Purple. Apart from fighting seizures, Purple Urkle is also a good variety to consume if you are dealing with neuropathic pain.

  3. Stephen Hawking Kush. Any cannabis strain with Kush genetics is a good candidate for dealing with epilepsy and its resulting seizures. However, since one of its parents is the high-CBD strain Harle-Tsu, Stephen Hawking Kush or SHK has strong neuroprotective capabilities as well. What’s more, all phenotypes of SHK possess a sweet combination of cherry and berry flavors, mixed with a hint of mint, which makes this a soothing strain that fights pain and nausea.

  4. Ringo’s Gift. This is a lesser-known high-CBD strain, although that doesn’t mean that it scrimps on its effects. In fact, this hybrid of Harle-Tsu and ACDC can range from a 1:1 CBD:THC ratio to a whopping 24:1 proportion. Taking its name from the medical marijuana activist and CBD pioneer Lawrence Ringo, Ringo’s Gift relaxes the muscles and gives a mellow mental stimulation to keep you from being couch-locked.

  5. Rafael (or Raphael). This strain is named after another prominent figure in cannabis history, researcher Raphael Mechoulam, whose team first isolated and synthesized CBD. This sativa-dominant strain has recorded ratios of up to 18:1 CBD:THC, which is ideal for dealing with seizure disorders, and even sleep and digestive problems.

The CDC has reported that 3.4 million Americans suffer from active epilepsy, more than 400,000 of whom are children. An estimated one in 26 people will also experience recurring seizures, in addition to the 150,000 Americans being diagnosed with epilepsy each year. This alarming statistic shows just how much work the scientific and medical communities have ahead of them to help manage this disorder. Fortunately, the social and professional apprehension that has clung to medical marijuana’s effectiveness in addressing epilepsy and seizure disorders are starting to fade. Soon, we may have more readily available sources of CBD oil and other products that are not only effective but also possess less harmful side-effects.