Revista de Neurología (RN) is published by IMR Press from Volume 79 Issue 11 (2024). Previous articles were published by under the CC-BY-NC-ND licence, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement.
1 Hospital Universitario y Politécnico La Fe, Valencia, España
2 Hospital Clínico y Provincial de Barcelona, Barcelona, España
3 Hospital Ruber Internacional, 28034 Madrid, España
4 Hospital Universitario de Santiago de Compostela, Santiago de Compostela, España
*Corresponding author: Dr. Vicente Villanueva. Unidad de Epilepsia Refractaria. Hospital Universitario y Politécnico La Fe. Av. Fernando Abril Martorell, 106. E-46026 Valencia.
E-mail: villanueva_vichab@gva.es
Abstract
Introduction: Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) are two serious epileptic syndromes with paediatric onset which are refractory to therapy and are associated with an important increase in mortality rates and comorbidities compared to the general population. These pathologies have a strong impact on the lives of patients and their families, because they undergo multiple pharmacological therapies (many of them without specific indication), with frequent changes due to poor efficacy and associated adverse effects. The specialists who care for these patients highlight unmet needs and the lack of specific, safe and effective treatments for better management of the syndrome.
Development: A group of four neurologists specializing in epilepsy has met to review the scientific literature and evaluate the efficacy and safety of oral solution cannabidiol in the treatment of these syndromes, both in randomized clinical trials (CT) and in some observational studies.
Conclusions: Cannabidiol is positioned as an innovative therapy that allows better control of epileptic seizures and comorbidities of DS and LGS, furthermore its efficacy and safety have been evaluated in more than 700 patients. In CTs, cannabidiol significantly reduced the percentage of convulsive seizures and drop seizures compared to placebo in patients with DS and LGS respectively, which could improve their quality of life and that of their family members. The most frequent adverse effects reported were somnolence and decreased appetite. Elevated liver aminotransferase levels were also reported, especially in patients given concomitant sodium valproate. This therapy may allow better control of the epileptic seizures associated with these syndromes.
Keywords
- Antiepileptic
- Cannabidiol
- Dravet syndrome
- Lennox-Gastaut syndrome
- Refractory epilepsy
- Severe epilepsy
