Medical Cannabis in the Treatment of Epilepsy

Introduction

Epilepsy is a progressive neurodegenerative disorder of motiveless, recurrent seizures, which is an abrupt burst of abnormal electrical brain activity. Conferring to the World Health Organization (WHO), epilepsy distresses 50 million people establishing 1% of the global problem of disease. Epilepsy can be developed by anyone, but more frequently onsets in young children and older adults. It is reported in 2021 that males develop epilepsy more often than females, perhaps due to more exposure to menace factors like head trauma and alcohol usage. Seizures are the foremost symptom of epilepsy and symptoms of seizures vary from person to person. A minor seizure may be hard to distinguish, it might last for a few seconds, and the individual may remain conscious while it happens. Symptoms of mild seizure comprise modifications in the sagacity of sight, perception, aroma, auditory, sense of touch, numbness, disorientation, and limb cramping. Robust seizures can induce tremors and overpowering muscle twitches that can last for a few seconds to quite a few minutes may cause confusion or loss of awareness and may lead to memory loss in the period after the seizure. Other manifestations include expression less staring, being inattentive, and doing monotonous motions.

Generalized and focal seizures are two different types of seizures. Generalized seizures involve the whole brain, whereas focal seizures or partial seizures affect only a portion of the brain. Generalized seizures comprise the entire brain and subtypes consist of 1) Absence seizures, often known as “petit mal seizures,” induce a sudden loss of attention, a blank look, and repetitive actions such as lip smacking or blinking. 2) Tonic seizures produce muscular stiffness in the legs, arms, or trunk. 3) Atonic seizures cause loss of muscular control, sometimes known as “drop seizures,” since the unexpected loss of muscle power can cause a rapid fall. 4) Repetitive, jerky muscular movements of the face, neck, and arms characterize chronic seizures. 5) Myoclonic seizures are characterized by impulsive, rapid twitching of the arms and legs. These seizures might congregate at times, 6) Tonic-clonic seizures, sometimes known as “grand mal seizures,” are characterized by symptoms such as body rigidity, shaking, lack of bladder or bowel control, tongue biting, loss of awareness following a seizure, and feeling mildly uncomfortable for a few hours.

There is no cure for epilepsy at present; nevertheless, it is possible to achieve success with drugs and other strategies including vagal nerve stimulation and ketogenic diets. Archeologically, there are earlier and ancient records of people utilizing medicinal cannabis to treat epilepsy. In the 19^th century (1843) an Irish physician, Dr. O’Shaughnessy, first introduced medicinal cannabis into Western medicine stimulated by his understandings and studies from his period working in India with the East India Company. He detected that cannabis tinctures fixed seizures in a febrile infant, demanding that medicine had found an anticonvulsant of the peak order (O'Shaughnessy, 1843). His publications supported cannabis use in Victorian England. Two notable neurologists of that era, J.R. Reynolds and William Gowers documented their practices with cannabis, predominantly for the cure of epilepsy. However, in the 20^th century, varying public morals and worries about cannabis’s psychoactive properties galvanized the global illegalization of cannabis. The cure for epilepsy remains an important clinical problem. Recently, the public and physicians have had considerable interest in using medical marijuana or its derivatives to treat seizures.