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What is the Difference Between Seizures and Epilepsy?

Seizures are known as the sudden uncontrolled disturbance in the brain’s electrical impulses. These seizures are often associated with changes in behavior, movement, or consciousness. The greatest proportion of people with seizures experience what is known as convulsions. Convulsion is known as the sudden contraction of a certain group of muscles or the whole body. Not all seizures can be categorized as epilepsy. In order to clinically diagnose someone as having epilepsy, he/she needs to have at least two seizures that are 24 hours apart in the past six months or to have recurrent seizures.

Epilepsy is perceived as a spectrum of disorders that involve a characteristic sign: unprovoked seizures. People with epilepsy may or may not have other health problems. Epilepsy can present in many forms and for different periods of time. Some people may experience sudden contractions in their muscular system, while others may experience loss of consciousness. The period of an epileptic attack can range from less than a minute to more than a few hours, which can be quite dangerous.

Seizures can be categorized, based on the extent of convulsions, into grand-mal seizures, petit-mal seizures, or Jacksonian seizures. Grand mal seizures involve the whole body, and they can be tonic, clonic, or tonic-clonic in nature. Petit mal seizures don’t usually involve convulsions, but the most characteristic sign in the sudden, brief lapses in consciousness, which are often known as the “absence seizures or empty stares”.

These seizures are caused by the sudden disruption in the normal electrical activity in the brain, which can occur from any site in the brain. This electrical disturbance can be localized in the area it originated from “focal seizure”, or it can spread to the whole brain, which is then called “generalized seizure”.

Unfortunately, people who are diagnosed with epilepsy will usually have the condition for the rest of their lives, and there are multiple stimulating factors that can provoke such seizures. These include:

  1. Prolonged exposure to rays, including sun rays and laptop and mobile screens.
  2. Drinking too much coffee on a daily basis.
  3. Stressful situations and emotional disturbances.

The occurrence of epileptic attacks can be predicted by one of the following factors:

  1. Flashes of light.
  2. Sudden changes in odor.
  3. Sudden changes in behavior.

Based on the fact that epilepsy has many types, there are a wide variety of symptoms that are different from one another. That is why it might be difficult for the treating physician to determine the exact cause of seizures in many cases.

Here is a list of the most common symptoms of epilepsy:

  1. Feeling confused for a short period of time.
  2. Empty stare: in this case, the person is unaware of his surroundings.
  3. Uncontrollable contractions or jerky movements.
  4. Disturbed consciousness or even complete loss of consciousness.
  5. Sudden fear or anxiety.
  6. Lapses in short-term memory.

What are the Causes of Epilepsy?

Epilepsy can be categorized, based on the underlying cause, into two major classes: primary and secondary epilepsy. Primary epilepsy often occurs spontaneously without the presence of any underlying cause. Meanwhile, secondary epilepsy occurs due to the presence of one or more of the following causes:

  • Brain injury
  • Very high body temperature or high-grade fever
  • Trauma
  • Stroke
  • Brain infections
  • Low blood glucose level
  • Structural disorders in the brain
  • Metabolic diseases

Epileptic Syndrome

The International League Against Epilepsy has set out new terminologies regarding different types of epileptic syndromes that usually involve epilepsy besides as conditions or symptoms. These epileptic syndromes include:

  • Lennox-Gastaut Syndrome (LGS)
  • Dravet Syndrome
  • Juvenile Myoclonic Epilepsy (JME)
  • Benign rolandic epilepsy (BRE)
  • Childhood absence epilepsy (CAE)
  • Infantile spasms (or West syndrome)

Treatment Options for Epilepsy

It is of great importance to remember that epilepsy is a spectrum of disorders. Therefore, certain antiepileptic drugs may work on some people but not work on others. There are many medications for epilepsy based on the type of seizure. They can include one of the following:

  1. Valproic acid
  2. Topiramate
  3. Clobazam
  4. Phenytoin
  5. Diazepam
  6. Carbamazepine

However, in a certain proportion of patients, all of these drugs are ineffective and the epileptic person will be categorized as having “treatment-resistant epilepsy”. Cannabidiol (CBD) has shown great effectiveness in both preclinical and clinical research in improving the outcomes in patients with certain epileptic syndromes and in those with treatment-resistant epilepsy.

What is the Role of CBD in Epilepsy?

Unlike the other properties of cannabidiol, CBD has been tested on actual human people with epilepsy to determine its effectiveness in controlling epileptic attacks in people with certain kinds of epilepsy syndromes or refractory epilepsy.

Clinical data significantly highlight the great efficacy of CBD oil in controlling epileptic attacks by either reducing the number of epileptic attacks or by reducing their severity.

 

In USA more and more people are using CBD to attenuate Epilepsy

Does Evidence Support the Use of CBD in Epilepsy in Humans?

Many research studies have been conducted to determine the effectiveness of CBD in treating epilepsy, including case reports, case series, cohort studies, and even randomized controlled trials.

The majority of their results highlight the great therapeutic potential of CBD in reducing the number as well as the severity of epileptic attacks in patients with treatment-resistant epilepsy.

Study design Subjects Dose of CBD Duration Outcomes Adverse effects
Survey-based study 117 parents of children with epilepsy 4.3 mg/kg/day 6.8 months (median duration of treatment) 85% of parents reported reduction in seizure frequency, while 14% of parents reported complete seizure freedom Weight gain
Retrospective cohort study 75 patients with refractory epilepsy ? 5.6 months (median observation period) 57% reported improvement to either seizure duration or frequency Augmented seizures, new seizures, somnolence, fatigue, or gastrointestinal symptoms
Retrospective multicenter study 74 children with refractory epilepsy 1 to 20 mg/kg/day 5.5 months (median duration of treatment) 89% reported reduction in seizure frequency Somnolence, fatigue, gastrointestinal symptoms, and irritability
Prospective, placebo-controlled clinical trial 9 adults with uncontrolled seizures (4 treated with CBD and 5 with placebo) 200 mg/kg/day 3 months 2 of 4 CBD-treated patients became seizure-free

1 had partial improvement in seizure frequency

1 did not show any improvement

No side effects reported
Prospective, placebo-controlled clinical trial 15 patients with uncontrollable seizures (8 with CBD and 7 with placebo) 200-300 mg/kg/day 8 to 18 weeks 4 of 8 CBD-treated patients became seizure-free

3 had reduced seizure frequency

1 had no improvement

Drowsiness
Prospective, placebo-controlled clinical trial 12 patients with uncontrolled seizures (6 treated with CBD and 6 with placebo) 200-300 mg/kg/day 3 weeks No significant change in seizure frequency or duration Mild drowsiness
Prospective, randomized, double-blinded, placebo-controlled clinical trial 12 patients with uncontrolled seizures (crossover design) 300 mg/kg/day Patients would start treatment with CBD or placebo and then be assigned the other intervention No significant change Drowsiness

A recent systematic review and meta-analysis included four randomized, placebo-controlled clinical trials of 550 patients with Lennox Gastaut syndrome treated with either CBD or placebo. CBD was administered orally in all of these patients. It was reported that the use of CBD 10 mg/kg/day was associated with a 19.5% reduction in seizure frequency compared to placebo. Meanwhile, patients treated with CBD 20 mg have shown a 19.9% reduction in seizure frequency compared to placebo. Adverse events were reported in 87.9% of patients treated with CBD and in 72.2% of patients treated with placebo (P < 0.001). The most common adverse events were somnolence and decreased appetite. Therefore, it was recommended that the use of CBD, in addition to the regular conventional therapy, would be beneficial in reducing the number of seizures in patients with the epileptic syndrome Lennox Gastaut syndrome.

In another meta-analysis of 16 clinical, observational trials of patients with treatment-resistant epilepsy, it was reported that CBD was associated with a significantly higher meaningful effect compared to placebo. The researchers reported no significant change in the adverse effect profile of CBD compared to placebo, even though adverse events were common with the short-term use of CBD rather than the long-term use.

It is important to note that CBD has been investigated as a potential alternative to other antiepileptic drugs in patients who no longer respond to conventional therapy or with certain epileptic syndromes. CBD is not recommended as a first-line medication for epilepsy.

People with epilepsy must first try the conventional therapy, and if it was deemed ineffective, then CBD can be tried, only under the observation of the treated physician.

https://pubmed.ncbi.nlm.nih.gov/31731110/
https://pubmed.ncbi.nlm.nih.gov/30390221/
https://www.bmj.com/content/365/bmj.l1141
https://pubmed.ncbi.nlm.nih.gov/27587196/

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