Kelly Hughes

Tags: CBD, glioma, epilepsy, glioblastoma, seizures

 

The problem: Glioma-related epilepsy can be difficult to treat and can have a significant negative impact on patients’ quality of life. 

 

Why do this study? The mainstays of seizure control in CNS tumors are a combination of tumor control (e.g. via surgery, chemotherapy, and radiation therapy) and medical management. However, this is often unsuccessful in completely controlling seizures. Interest has been increasing in using medicinal cannabis, cannabidiol (CBD), as an anti-epileptic treatment strategy, and this may help with seizure control in glioma patients.

 

The study: This report details a case study of a patient with recurrent glioma whose seizures persisted despite multiple anti-epileptic treatments, but were significantly improved with CBD use. The report describes a 32 year old woman who was diagnosed with right frontal grade 2 oligodendroglioma in 2010. Despite treatment, the tumor progressed to an inoperable stage in 2016. In the early stages of disease, her symptoms started as focal sensory seizures that became increasingly resistant to treatment and ultimately progressed to focal motor seizures. Throughout this progression she was treated with multiple anti-epileptic medications that failed to control her multiple daily seizures and dose increases were often limited by side effects. Up to November 2017, she experienced 10 or more seizures daily, despite taking multiple anti-epileptics. In November 2017, CBD was added to her treatment regimen and within two weeks, her seizures reduced to an average of 1 or fewer seizures daily. She took 750 mg of CBD, twice daily with mild fatigue as the only adverse side effect. During this time, other anti-epileptic medications were reduced or stopped, and her seizures remained controlled throughout CBD treatment. CBD did not appear to impact tumor progression. The patient had previously attempted smoking marijuana in the without any benefit.

 

Conclusions: This case suggests that CBD may offer significant relief from the seizures in glioma-related epilepsy.

 

What does this study add? This study suggests that CBD may be an additional treatment option for patients with glioma-related epilepsy. In addition to research suggesting that CBD may be beneficial in treating other forms of intractable epilepsy, this work suggests that glioma-related epilepsy may also benefit from CBD treatment.  However, more studies are needed to evaluate CBD as an anti-epileptic in patients with glioma-related seizures.

 

Funder: None stated

 

Author conflicts: None

 

Commentary: (Kelly Hughes).

Medical cannabis has been useful in cancer treatments, mainly for addressing anorexia and the nausea and vomiting associated with chemotherapy treatments. There is less research on cannabis use for treating tumor-associated symptoms. There have been a number of studies suggesting that CBD may be a viable treatment option for intractable epilepsy, however epilepsy can have a number of underlying causes, so it is important to test how effective CBD may be against epilepsy originating from different sources. This study suggests that CBD could offer significant relief to patients with glioma-related epilepsy, which is in line with previous studies, but it is very likely that the anti-epileptic effects described in this case were a result of CBD combined with the other anti-epileptics drugs. However, it is important to note that CBD has wide-ranging effect on the metabolism of other drugs, including anti-epileptic medications.  Therefore, it is possible that CBDs’ effect in this case was not (only) due to anti-seizure effects, but rather to increases in serum levels of the other anti-seizure medications this patient was taking.