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Cannabis & Epilepsy

In this series of articles, our medical students will discuss a range of topics from medical ethics to the NHS to public health to medical conditions to clinical governance

Epilepsy is estimated to affect more than 500,000 people in the UK. This means that almost one in every 100 people has the condition. ~ The NHS

Already being approved in America, the European Commission has also approved a drug called Epidyolex containing cannabis for the use in two types of severe, rare epilepsy. Although the component of the cannabis that gives you a ‘high’ (tetrahydrocannabinol - THC ) has been removed, the NHS is yet to approve the drug. This drug can only be prescribed to persons over the age of 2.

Epilepsy is a common condition that affects the brain and causes frequent seizures. Seizures are bursts of electrical activity in the brain that temporarily affect how it works. They can cause a wide range of symptoms. Epilepsy can start at any age, but usually starts either in childhood or in people over 60. It's often lifelong, but can sometimes get slowly better over time. ~ The NHS

Lennox-Gastaut syndrome and Dravet syndrome are two incredibly rare, but severe, forms of epilepsy.

Lennox-Gastaut syndrome is most common at the age of 3-5, however it can continue into adulthood. It can be caused by brain damage from trauma during pregnancy, inflammation of the brain (encephalitis) and meningitis which can also causes swelling of the meninges of the brain. It can also be caused by gene defects. Symptoms include daily seizures which occur commonly in REM sleep. The seizures are tonic, which means they cause all the muscles of the body to tighten, causing your body to stiffen up; they last 60 seconds. This can cause injury as it often involves falling involuntarily to the floor. Children with this syndrome will have moderate to severe learning difficulties. A person can be diagnosed with this syndrome by using an EEG (electroencephalogram).

Hot temperatures and fever often trigger seizures in Dravet syndrome, and these seizures are termed febrile seizures. Signs begin to develop around 6 to 10 months of age. The seizures are tonic-clonic seizures, which have two phases. There is a tonic phase first, where you lose awareness and your muscles go stiff. Then there is a clonic phase where the limbs shudder quickly and there may be a loss of control of the bowels and bladder. Breathing may be difficult causing the mouth to go a bit blue. These seizures normally last between 1 and 3 minutes. It is caused by a mutation in a gene called the SCN1A gene.

Some people with these conditions have travelled to the Neverlands to buy cannabis medicines, however are still not happy with the approved version as it lacks tetrahydrocannabinol, which they claim is what helps the most. GW Pharma, the creator company of Epidyolex, is continuing to persuade NICE to allow its drug into the NHS.