A Survey on Cannabinoid Treatment of Pediatric Epilepsy Among Neuropediatricians in Scandinavia and Germany.

Claus Klingenberg,Helle Hjalgrim,Thorsten Gerstner,George Mouslet

doi:10.3389/fped.2020.00416

Abstract

Objectives: There is an increasing interest in cannabinoid-based products for the treatment of refractory pediatric epilepsy. However, a licensed cannabidiol (CBD) product was first approved for use by the European regulatory authorities in 2019. We aimed to obtain knowledge about clinical experience and attitudes toward cannabinoid use for epilepsy treatment among neuropediatricians in Scandinavia and Germany in the era before a CBD-product was commercially licensed and available.Study design: An internet-based questionnaire (Survey Monkey) was distributed by email to members of neuropediatric societies in Sweden, Germany, Denmark, and Norway between February and April 2018. One reminder email was sent.Results: Eighty-six responded. Only 10 of 86 (12%) respondents had personal experience with off-label prescription of cannabinoid-based products, mainly for severe refractory pediatric epilepsies like Dravet syndrome and Lennox-Gastaut syndrome. However, 49 respondents (57%) had been exposed to relatives of patients that had requested or wanted to discuss cannabinoid therapy, and 32 (37%) respondents knew about cannabinoid self-medication. The knowledge regarding cannabinoid-based therapy among the respondents was overall limited. Main reasons for not prescribing cannabinoid-based therapy were concerns about law regulations and lack of an available product.Conclusion: Off-label cannabinoid-based therapy for pediatric epilepsy was not widely prescribed by neuropediatricians in Scandinavia and Germany in 2018.

Highlights

Over the last decade there has been an increasing interest in cannabinoid-based products for the treatment of refractory pediatric epilepsy [1]
A Survey on Cannabinoid Treatment of Pediatric Epilepsy probably mediated by modulation of intracellular calcium levels, through inhibition of the G-protein coupled receptor GPR55 and activation of the transient receptor channel TRPV1, and the inhibition of adenosine re-uptake [2]
Until a few years ago most data on the use of CBD-enriched extracts to treat pediatric epilepsy had been based on observational studies, mainly from the USA

Summary

Introduction

Over the last decade there has been an increasing interest in cannabinoid-based products for the treatment of refractory pediatric epilepsy [1]. Since 2016, three randomized placebo-controlled adjunctivetherapy trials of purified CBD-products including children and adolescents with refractory epilepsy have been published [3,4,5]. In these trials, CBD was superior to placebo in reducing the frequency of convulsive seizures in patients with Dravet syndrome [3], and in reducing the frequency of drop-seizures in patients with Lennox-Gastaut syndrome (LGS) [4, 5]

Objectives

Methods

Results