With over half of epileptics still having seizures while on seizure meds-

why not try an alternative option; such as cannabis?

Alexzander Pavon
Senior ProjectAdvisor: Britt Blasdell

Abstract

The treatment of epilepsy will be my life’s journey. Having Juvenile Onset of Myoclonic
Epilepsy since I was thirteen, gives me a unique perspective into the development of future
treatment options. In this paper, I study what exactly epilepsy is and why cannabis treatment
works for seizure reduction. There has been a huge stigma attached to the use of cannabis for
medicinal purposes especially in treating children.There are more and more studies that are
showing the immense benefits for treating epilepsy with cannabinoids. Cannabis and
cannabinoids derived from the marijauna plant have been shown in recent studies to carry
relatively low-risk and many positive health benefits not just in treating epilepsy but also in
treating other devastating diseases such as cancer, parkinsons, PTSD, anxiety and autism.The
health care system and physicians won’t provide cannabis to their patients because it remains
classified by the federal government as a schedule 1 drug, making it technically illegal to use for
any purpose.Marijauna was classified as a schedule 1 drug along with heroin and psychedelics in
1961 under the “Controlled Substances Act” .My hope is to find what treatment options that
work to control my seizures. Having options that will allow one to have seizure reduction or
elimination along with best quality of life should not be limited by misconceptions, stigmas and
outdated laws.

12th Grade Humanities

Animas High School
April 15, 2021
Introduction

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 Epilepsy isn’t a new disorder in fact there are descriptions of epileptic seizures throughout

ancient history. The term 'epilepsy originates from the Greek verb “epilambanein” which

means ‘to seize, possess, or afflict’. It was thought to be a Herculean disease because it was

believed to affect the semi-god Hercules (Gottfried et al., 1805). It was also believed to be a

divine punishment for sin in much of early history. Plato’s law would make it a crime if you sold

a slave that showed signs of epilepsy. Hippocrates, who is considered the father of medicine, was

the first who attempted a scientific approach toward the study of epilepsy by suggesting possible

etiology and therapy for the disease. He was the first to attribute the etiology of epilepsy to brain

dysfunction (Hippocrate, 1849a), stressing the role of heredity in the disease. He also coined the

phrase “Gran Mal'' which is used to describe a particular type of seizure.

Today, epilepsy as defined by the CDC : “Epilepsy is a broad term used for a brain disorder

that causes seizures.” (“About Epilepsy”) There are many different types of epilepsy. There are

also many different kinds of seizures. Epilepsy is basically caused by abnormal brain activity.

There are electrical impulses in the brain that are happening all the time in a rhythmic nature.

“There is a balance between excitatory brain cells which cause activity and inhibitory brain cells

that prevent electrical activity. In an epileptics brain that rhythm is disrupted by too much or too

little of inhibitory or excitatory cells. When the rhythm is disrupted a seizure will occur. This

abnormal activity can be caused by many factors such as trauma or head injury, genetics, tumor

or stroke, infectious disease and developmental disorders such as Autism.”(“About Epilepsy”)

Every year about 150,000 Americans are diagnosed with an epileptic disorder. About 50

million people worldwide have epilepsy, making it the fourth most common neurological disease

after migraines, stroke and alzhimers. (Djordevic). Epilepsy can happen to anyone but has a

much higher prevalence in young children, older adults 65+, men and in areas of Latin America

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and Africa. Of those 50 million people that are taking anti-epileptic meds (AED) 56% still have

seizures.(medalerthelp.org)

What is a Seizure?

Now we are getting to the nuts and bolts of the issue with being diagnosed with epilepsy,

seizures. A seizure is a sudden rush of electrical activity to the brain that causes one of the four

types of seizures. Most epileptic will have a combination of different types of seizures at

different times. There are things that can “trigger” a seizure in epileptics and the triggers are

unique to the individual. Triggers can include emotional stress,anxiety, lack of sleep, flashing

lights, hyperventilation, physical stress, certain foods, alcohol and exercise.“Triggers and

Epilepsy | MyEpilepsyTeam.” Antiepileptic meds work to control the seizures but there are times

when the electrical activity breaks through the seizure threshold and causes a seizure. Sometimes

there can be a direct trigger and sometimes it can just happen.

There are four different types of seizures, the most common one when most people think of

epilepsy is the one called tonic clonic (Gran Mal). This one is what would be considered a “big”

seizure. It causes the body to become rigid, the arms, legs and head to jerk violently. There will

be a loss of consciousness,loss of motor function, sometimes a loss of bowel function and

hyperventilation. If a tonic clonic lasts longer than five minutes it could potentially cause brain

damage. Recovery from this type of seizure can take many hours to days. It’s said that a tonic

clonic seizure is as taxing on a body as running a marathon. (“About Epilepsy”)

Next type of seizure is called an absence seizure. They are very common, especially in

adolescence. These seizures last only seconds and there is no change in muscle tone. They can

take place many times a day, often interpreted as daydreaming or spacing out. They cause

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confusion and memory loss. Some report that they see dark halos and ringing in their ears.

Others say it feels like their brain is off-line and trying to reboot, fragmenting where they are and

what they were previously doing. (“About Epilepsy”)

Another type of seizure is at times overlooked as a seizure. Sometimes people misinterpret it

for a tic. This is called a myoclonic seizure. This is where there will be a sudden unintended

jerking of arms, legs, neck and face. The electrical activity in the brain causes a muscle

contraction in the body.(“What to Expect If You Have Myoclonic Epilepsy”) If you were to be

brushing your teeth, you’d fling your toothbrush across the bathroom, or when eating you can

drop your fork or plate. There is no loss of consciousness and only a momentary loss of motor

function and impaired speech if the seizure effects the muscles in the face or jaw. These are

uncomfortable to have. It makes one feel like pins and needles are running through the body.

The fourth type of seizure is called: Atonic seizure. This is when there is a brief and complete

loss of all muscle tone. They can just fall to the ground in a limp manner. They can often be

described as looking like a rag doll. It can last only seconds to minutes and can take hours to

recover fully. (“Atonic Seizures”)

Seizures can be exhausting for the person who is having them. The longer or more frequent

the seizures the more worn out the person will be and the longer it will take to fully recover.

Neurons are screaming during a seizure and just like a vocal cord if you scream for long enough

it will damage the vocal cord. If any one of these types of seizures lasts long enough and is

frequent enough there will be damage done to the neurons in the brain. This is why it is so

important to gain control over seizures. There are life-altering effects from uncontrolled seizure

activity.

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 There are two forms of epilepsy that are considered the most severe, Dravet Syndrome and

Lennox-Gastaut Syndrome. Both usually have an onset in infancy and the seizures are severe and

constant. Dravet Syndrome is rare and about 85% of children survive but have some form of

mental disabilities/retardation from the seizures that occured in infancy. Lennox-Gastaut

Syndrome is considered to be a catastrophic form of epilepsy.These babies and small children

can have up to hundreds of seizures a week.(“Lennox-Gastaut Syndrome Information Page |

National Institute of Neurological Disorders and Stroke”) Their brains stop developing because

they cannot process any other activity because of the constant seizing . These forms of epilepsy

are drug-resistant and Lennox-Gastaut Syndrome is fatal in a large number of cases.

Research and Analysis

There are about twenty different drugs that are in the toolbox of the neurologists to treat

epilepsy from babies to adults. Sometimes, you have to take a combination of two or even three

to control seizures.Medication helps to control seizures but not abnormal brain activity. There is

no perfect medication. Epileptics are really just guinea pigs in the beginning of their diagnosis.

Physicians run through the gamut of FDA regulated and approved medication if one doesn’t

work or the side effects outweigh the seizure reduction then on to the next pill(s). “Most common

side effects from seizure medications are: change in mood, suicidal thoughts and behavior,

aggression,rage,depression, fatigue, loss of coordination, vision change, weight gain, stomach

upset, fatty liver disease and fish-like body odor. In 56% of the cases epileptics still experience

some form of seizures despite being on seizure meds.” .(medalerthelp.org)

With the unpleasant side effects and sometimes lack of efficacy of FDA regulated medication

it’s no wonder patients that suffer from epilepsy are taking their health into their own hands and

finding new and somewhat controversial ways of managing their disease. According to Krishina

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Andavola, “ There is no perfect drug in the treatment of epilepsy for everyone. It’s a unique and

complicated disease that is also unique in the treatment. With almost half of the patients either

experiencing some form of seizures or suffering from awful side effects from the anitepileptic

seizure meds, why not open the door to cannabis options?” (“Stoned Kids”).

The most compelling argument for cannabinoids and treating epilepsy is in the case of

Charlotte Figi. Charlotte began to have seizures at three months of age and with each year of life

the seizures became more severe and frequent. According to her parents Charlotte was having up

to 300 seizures a week by three years of age. She began to decline in all of her cognitive

development. By the age of three she was diagnosed with Dravet syndrome. She was on seven

different types of antiepileptic meds but to no avail. Her doctors would have to put her into

medically induced comas just to allow her body and brain time to heal from the near constant

seizing. By the time she was five her parents decided to try cannabis, her doctors had told them

all medical options had been exhausted at that point. Enter the Stanley brothers: They were

brothers that grew medical marijauna and distributed in Colorado. They created a strain of

marijauna that was originally called, “Hippies Disappointment” because of the extremely low

THC and high CBD properties. 30:1 CBD to THC. (Marketing)

Charlotte Figi and her family tried this strain from the Stanley brothers and saw immediate

improvements in Charlotte within the first week. Her family said that she went from 300 seizures

a week to none.(Pickard)

Matt Figi, Charlotte’s father is quoted saying, “I literally see Charlotte’s brain making

connections that haven’t been made in years,” (Pickard). Because of the success that Charlotte

experienced with the Stanley Brothers strain of marijauna they changed the name to honour her

to :”Charlotte's Webb”.(Pickard).

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 After Charlotte’s case was made public, more and more doctors and researchers are open to

the use of cannabis as a viable therapeutic option — Dr Sanjay Gupta, neurosurgeon and

professor of neurosurgery at Anschutz Hospital, probably being the most open of these. After

hearing about Charlotte’s case, he very publicly made a 180 degree turn about his stance on

medical marijuana stating:“It doesn’t have a high potential for abuse, and there are very

legitimate medical applications. In fact, sometimes Marijuana is the only thing that works. It is

irresponsible not to provide the best care we can as a medical community, care that could involve

Marijuana. We have been terribly and systematically misled for nearly 70 years in the United

States, and I apologize for my own role in that.”(Marketing)

New Hope in Ancient History

The latest trend and hopeful helpful cure is in the cannabis plant. This isn’t “new” at all

though. In fact, cannabis was used to treat all different types of ailments for thousands and

thousands years spanning the globe. In the United States, a wave of regulations made access to

cannabis more difficult starting from the late 1900s, ultimately leading to the Marihuana Tax Act

of 1937, which ended up making cannabis use a federal offense.” Interestingly, however, this

recent period of 20th century opposition is actually just a small speck in the wider 6,000-year

timeline of cannabis. After all, the plant has been widely regarded for its therapeutic potential

for many millennia by different cultures around the world.” (Desjandis)

TimeLine of Cannabis:

4000 BC: Pan-p’o village

Cannabis was regarded among “five grains” in China, and was farmed as a major food crop.

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2737 BC: Pen Ts’ao Ching

Earliest record of cannabis as a medicinal drug. At this time, Emperor Shen-Nung recognized its

treatment properties for over 100 ailments such as gout, rheumatism, and malaria.

2000-1000 BC: Ayurvedic Medicine

Open religious use of cannabis allowed for exploration of medical benefits. During this period, it

was used to treat a variety of ailments such as epilepsy, rabies, anxiety, and bronchitis.

1550 BC: Ebers Papyrus

Egyptian medical papyrus of medical knowledge notes that medical cannabis can treat

inflammation.

1000 AD: Treats Epilepsy

Arabic scholars al-Mayusi and al-Badri regard cannabis as an effective treatment for epilepsy.

1839: William O’Shaughnessy

Irish doctor William O’Shaughnessy introduced the therapeutic uses of cannabis to Western

medicine. He concluded it had no negative medicinal effects, and the plant’s use in a

pharmaceutical context would rapidly rise thereafter.

1900: Medical Cannabis

Medical cannabis was used to treat nausea, rheumatism, and labor pain. At this point in time, it is

available over-the-counter in medications such as “Piso’s cure” and “One day cough cure”.

(October 2014, “Marijuana’s History: How One Plant Spread through the World”)

Can this history teach us something? Why was this plant that was used for thousands of years

to treat so many ailments banned from use? Is it the new hope or unregulated snake oil? Many

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epileptics have hope in the science of the plant itself. The cannabis plant contains different

combinations of something called cannabinoids. These cannabinoids bind to our

endocannabinoid system receptors in our own bodies. The receptors are within the system,CB1

receptors are in brian. CB2 receptors are in our spleen. This is where the term “head high” or

“body high” can come from. Basically,it depends on what cannabinoids the strain has and what

receptors it binds to.Our endocannabinoid system naturally helps us to relax, eat ,sleep and

forget. According to Dr. Sanjay Gupta, “Using the cannabis plant by either smoking it or

ingesting it will bind to these receptors and will have the therapeutic benefits The human body,

naturally producing cannabinoids, has cannabinoid receptors — CB1 and CB2. CB1 receptors

are mainly found in the brain and are responsible for dealing with things like pain, movement

coordination, cognitive abilities (thinking, memory), appetite and emotions. CB2 receptors are

more commonly found in the immune system and have an effect on things like pain and

inflammation.

When CBD enters the body, it stimulates the body to create more of its own cannabinoids, thus

producing the beneficial effects seen in so many patients.” (Pickard).

While medical marijuana may not always cure epilepsy, it can greatly reduce the appearance

of symptoms like seizures. It can also make seizures more manageable, and many people who

suffer from epilepsy may take cannabis as both a preventive measure and a treatment for

symptoms in progress.

According to Krishina Andavola, an investigative journalist “The psychoactive effects of

THC can help a person experience deeper relaxation, and THC can help calm excited neural

paths. While CBD does not cause psychoactive effects, it binds to pain receptors and other areas

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of the brain, resulting in anti-inflammatory properties. Ultimately, there are many ways medical

marijuana can benefit epileptics, and it’s up to the individual to find a form and method that

works best.After a seizure, an epileptic may feel lethargic, confused, irritable, or restless.

Medical marijuana can help eliminate these stressful feelings and offer relaxation after a seizure.

Some patients benefit from daily CBD doses to eliminate or greatly reduce the chance of a

seizure.” (“Benefits of Marijuana for Epileptics”)

Most are skeptical of the therapeutic benefits of THC, which is just one of the cannabinoids

that is in the cannabis plant. THC binds to the CB1 receptor in the brain and will have a

psychoactive benefit.THC that binds to the CB1 receptor shows to have an anticonvulsant effect

on the brain.(Stockings et al.) Since a large majority of epileptics are children and even babies, it

feels wrong and it’s illegal to give your child cannabis. But, the efficacy rate has shown to be the

same in seizure reduction as it is with pharmacological medication. According to Dr. Lubbart

M.D. ‘Adult participants in a recent study included individuals who suffered from epilepsy and

found no success with existing treatment. During the study, an occurrence of seizures among

participants dropped by an average of 54%. The study also indicated greater success for

individuals who took medical marijuana in combination with anti-seizure medication, which

shows that medical marijuana may help augment existing treatments and limit the appearance of

dangerous epileptic symptoms.”

The most interesting thing about treating epilepsy with cannabis is that in the two

catastrophic forms of epilepsy Dravet Syndrome and Lennox-Gastaut Syndrome which are

considered to be drug-resistant respond to cannabis treatment.Some children go from 50 +

seizures a day to one or two.(https://www.lgsfoundation.org/for-families).

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 In the case of Charlotte Figi the evidence is unbelievable compelling. I’m sure there are many

other families out there that are struggling with these types of devastating and hard to treat

diseases that leave them wondering…”what can we do?” The fact that they might not seek

treatment with cannabis because of its legality is not only a shame it’s almost inhumane.

Conclusion

Leaving the moral and legal issues aside for the therapeutic use of cannabis plant is the issue

that it is a crop plant with over five hundred different strains each having a different combination

of cannabinoids. So, basically each is a different medicine. The devil lies in the details of this

plant. Figuring out how to repeat treatment when one strain shows that it can work for a patient

is that hardest part. In the United States it is still a schedule 1 drug making it Federally illegal.

This makes it extremely hard to do FDA clinical trials. Everything we ingest is subject to an

FDA clinical trial, from toothpaste to baby formula. The FDA is a Federally regulated and

therefore subject to federal funding. It’s almost impossible to attain the amount of money to

conduct a clinical trial without federal funding.It essentially also makes the study illeagal.

Clinical trials are crucial to understand and replicate the specific combination of the cannabinoid

properties that can truly help those that respond to it. Developing a data bank that identifies what

is the exact chemical make-up of each strain of cannabis in order to enable the right treatment for

patients would be a start to understanding how it helps.. Also, having the FDA regulate the

producers is crucial as well. Having no FDA regulation those that treat themselves with cannabis

now are taking a gamble that it could just be snake oil. There is no regulation or real

consequence for the cannabis producer to have exactly what it claims on the label.Making this a

possible life-treating choice in treatment options.

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 Hopefully this paper can shed some light on what it’s like to battle epilepsy. It might seem

like at times that westeren medicine has failed the epileptic. But, possibly looking into the past

could help us move forward. Cannabis could help some live a better life. It is the responsibility

of scientists to learn how to use it better,to precise it and take it to the next level. Why not look

at it’s potential and put it in the physicians toolbox to treat patients? There are plenty of

pharmacological drugs that can debilitate children and adults. Time is here to seek alternative

ways to envision treatment of this disease.

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