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Epilepsy patient with researcher
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Epilepsy

Symptoms, causes and treatment of paediatric epilepsy

Katelyn Lambert suffers from Dravet syndrome, a severe form of childhood epilepsy unresponsive to current anticonvulsant drugs. We’re developing cannabinoid medicines to reduce seizures, mortality and intellectual disability.

We have a sophisticated research program on epilepsy spanning preclinical disease models to clinical trials.

  • Our PELICAN study is examining community experiences of the use of medicinal cannabis preparations to treat childhood epilepsy. We are also examining the cannabinoid and terpenoid content of the oils and tinctures that are being used.
  • We are examining phytocannabinoids, terpenoids and full-spectrum cannabis extracts in preclinical models of childhood epilepsy, to tease out which cannabinoids and cannabinoid combinations may optimally reduce seizures, mortality and intellectual disability. Our preliminary results show that, beyond CBD, additional phytocannabinoids are effective in reducing seizures.
  • We are conducting cellular studies to determine the anticonvulsant mechanisms of action of cannabinoids. We have discovered a novel mode of action through which CBD acts to reduce neuronal excitability.
  • We are contributing our expertise to the current NSW government-funded trial of cannabinoids in paediatric epilepsy.

Epilepsy, also known as a seizure disorder, is a common neurological condition that affects the central nervous system.

Epilepsy is diagnosed when a person experiences two or more unprovoked seizures. 'Unprovoked' means that the seizures were not the result of another treatable medical condition – such as head trauma, infection, drug or alcohol intoxication, or diabetes.

A seizure is a temporary behavioural disturbance due to an interruption of the electrical activity in the brain. 

During normal brain function, tiny electrical charges are used by neurons (a type of cell in the brain) to communicate with each other and the rest of the body. A seizure occurs when this normal activity is disrupted by a sudden burst of abnormal electrical activity in the brain.

Depending on the type of seizure and part of the brain that is affected, this excessive electrical activity produces signs and symptoms that can vary from person to person.

Different signs and symptoms of a seizure may include:

  • sensory disturbances such as numbness or tingling, an unusual taste or a strange smell, vision loss or hallucinations, speech impairment and/or pain in the body
  • mental confusion, loss of awareness, staring or loss of consciousness
  • repetitive, non-purposeful movements such as wringing your hands or lip-smacking
  • abnormal muscle movements such as limpness, stiffness or convulsions (twitching/jerking movements).

Epilepsy affects approximately 1% of the population worldwide.

Epilepsy affects people of all ages, races and socio-economic status; however, epilepsy incidence is highest in children and adults over 55.

Epilepsy has many different causes that can be classified as structural/metabolic, genetic or unknown. 

Structural/metabolic epilepsies are a secondary result of events such as difficulties during childbirth, infection, severe head trauma, brain tumour or stroke.

For some patients, their epilepsy has a genetic cause, which means that it develops from an error in their DNA.

Unfortunately, in 60% of patients the cause of epilepsy is considered unknown.

Anticonvulsant medications (AEDs) are the primary treatment for epilepsy patients. Most epilepsy patients are able to control their seizures with AEDs.

However, 30% of patients do not respond to AEDs and continue to have uncontrolled seizures, which is called refractory epilepsy. Additional treatment options for patients with refractory epilepsy include surgery, use of medical devices (eg electrical stimulation of the vagal nerve) or dietary therapies (eg ketogenic diet).

The ancient Sumerians and Assyrians used cannabis to treat epilepsy as early as 1800 BC. Research conducted during the 1970s and onwards has reported anticonvulsant effects of cannabinoids such as CBD, THC and CBDV in animal models and small-scale human trials.

More recently, an overwhelming groundswell of community support for medicinal cannabis use in childhood epilepsy has arisen based on the life-changing stories of children like Katelyn Lambert.

In 2017 a landmark placebo-controlled trial showed that CBD reduced seizures in childhood epilepsy.

At the Lambert Initiative, we are further exploring the efficacy of CBD, not only in reducing seizures, but in increasing lifespan and reversing intellectual disability. Beyond CBD, we believe we can improve cannabinoid-based therapeutics in epilepsy, as other phytocannabinoids and terpenoids have anticonvulsant effects.