Epilepsy, which causes uncontrolled bursts in the electrical activity of the brain, is the most common of the disorders related to brain activity. It’s a challenging, life-affecting disease for which you can’t always find a suitable medicine, at least not a very easy one. In this article, we explore epilepsy, the endocannabinoid system behind it, and whether it could CBD oil can be helpful in the treatment of epilepsy.

What is epilepsy?

Epilepsy is a chronic brain disease that affects the brain’s electrical activity. It is the most common of the serious neurological diseases and occurs more in men than in women. Epilepsy also occurs in children and animals such as dogs and cats. Globally, the diagnosis of epilepsy is approx. percent of people.

Epilepsy involves both a disorder of the brain’s electrical activity and inflammation of the nervous system in the brain. (1)

A disturbance in the electrical activity of the brain is either excessive discharge or synchronous activity of neurons (1). Inflammation of the nervous system is believed to be part of the cause of epileptic seizures because it occurs both before and after seizures (2). Inflammation of the nervous system is a normal, natural reaction of the body, but it seems that there is an overreaction in the sick brain. The endocannabinoid system is involved in inflammatory pathways and is involved in both the activation of the inflammatory response and its extinguishment (2,3), CBD oil has been found to alleviate inflammation (4,5) .

Epilepsy symptoms

The symptoms of epilepsy are clear and very similar in almost all sufferers. Epilepsy is accompanied by episodes of unconsciousness or loss of consciousness, during which the body can convulse violently. The symptoms vary slightly depending on the type of epilepsy and the patient, but the characteristic features are very similar to each other.

Epilepsy can occur in connection with another disease, such as a brain tumor, and sometimes a brain tumor or another neurological disease can cause an epileptic seizure. A seizure, which is the clearest and first symptom of epilepsy, is often a frightening experience for both the person having the seizure and their loved ones. After the first seizure, other possible seizure-causing diseases are ruled out, and if there are more than one seizures and no reason for the seizure is found, it is always treated as epilepsy. (1)

Epilepsy with local onset causes premonitory symptoms

Localized epilepsy occurs in the brain only in the neurons of the other hemisphere, usually very locally. These attacks are characterized by premonitory symptoms, which appear as sensory hallucinations such as auditory and visual hallucinations. Soon after, the consciousness becomes blurred, and the person no longer reacts to external stimuli. Limbs may jerk and make uncontrollable movements, and the others did not have any of this. Seizures of local onset usually last a few minutes and may progress to a convulsive attack. (6)

Juvenile myoclonic epilepsy

Adolescent myoclonic epilepsy (Janz’s epilepsy) is often difficult to detect. To get a correct diagnosis, an EEG study that measures the electrical activity of the brain and an in-depth picture of the disease are always needed. Adolescent myoclonic epilepsy usually starts between 13 and 16 years of age and is characterized by mild absence seizures and especially morning muscle twitching. Video games, sleep deprivation and heavy alcohol consumption increase myoclonic symptoms. (7,8)

Bright and flashing lights may trigger epileptic seizures or symptoms typical of epilepsy, even if epilepsy has not been diagnosed.

An epileptic seizure

An epileptic seizure can happen to anyone. One in ten people will have a one-time epileptic seizure during their lifetime, but a single seizure is not yet actually a sign of the disease. An epileptic attack is the result of too large an electrical discharge in the neurons of the brain (1) and they are classified according to the types into three; focal, generalized and unknown seizures.

An epileptic seizure is characterized by violent spasms of the body and twisting of the limbs. Often during an attack, a person bites their tongue and may also defecate underneath. Foam may form at the mouth and there is a risk of suffocation. The attack usually passes within a few minutes, but the confusion and fatigue can continue for hours after the attack. (1,10)

CBD oil seems to reduce seizures even surprisingly effectively. Studies have shown that depending on the dose, type of epilepsy, etc. depending, the seizures clearly decreased in almost half of the participants in the studies. (4,5,12)

A long history of epilepsy

Epilepsy has existed among humans and animals since the beginning of time. It was originally believed that epilepsy was a demon sent by the moon god and the two even had the same name; Puppet. Later, more demons were added to the list of culprits, and for a long time epilepsy was believed to be of supernatural origin. Epilepsy was treated with exorcism spells and magic, but also with hemp extracts. By the time the attack was over in a few minutes, as it happens today, false notions arose that belief treatments such as spells had made the patient more effective and cured. Today, it is no longer believed that epilepsy was caused by a demon, but its birth and origin is still as big a mystery as it was thousands of years ago (9).

Epilepsy of a child

The reasons behind a child’s epilepsy can be very diverse. It can be a structural defect, brain damage at birth or hereditary sensitivity. Sometimes no explanation can be found. In children, epilepsy is slightly less common than in adults, but the seizures are very similar. On the other hand, children often have more seizures than adults and they can be very violent. They include loss of consciousness or blacking out, as well as muscle and body twitching and convulsions. The quality, number and type of scenes may vary, but their basic features are very similar.

Epilepsy in children is usually treated quite well with medication, and only about a third need more than one medication. (10)

Medicines do not work for epilepsy in about a third of patients. Children often have more severe forms of epilepsy and their treatment with CBD has been studied surprisingly much. For example, Epidiolex®, a product containing CBD isolate approved by the FDA for epilepsy in 2018, has been studied and also used as a medicine, either alongside other treatments or individually. It is prescribed from the age of 1 and has been found to be both suitable and has a good effect on children. (5,13)

Charlotte’s web

Charlotte Figi, an American girl born in 2006 (d. 2020), who suffered from genetic childhood epilepsy from the age of 3 months deserves a special mention. Charlotte had up to 300 strong epileptic seizures every month, which of course eventually affected her age-appropriate development as well. Charlotte’s epilepsy was drug-resistant, meaning that the seizures could not be controlled with existing drugs, and finally Charlotte’s parents decided to try CBD oil as medicine. The rest is history, as Charlotte’s Web is a cannabis strain renamed after Charlotte. CBD oil made from that variety contains very little THC relative to and when CBD is present full spectrum oil, it is more effective than isolate in its treatment. Charlotte’s seizures lessened CBDwith the use of , to 2-3 nocturnal seizures per month and his development was able to continue. Slower than his twin sister, but he learned to talk, walk and eat independently. Charlotte’s story of the relief brought by CBD was widely covered in the media and has greatly contributed to the research of CBD and epilepsy. (11)

Researchers have noticed that the number of cannabinoid receptors in the brain of people with epilepsy is clearly lower compared to healthy people. Activation of cannabinoid receptors reduces inflammation in the nervous system and protects against possible damage from an epileptic attack.

The endocannabinoid system and epilepsy

The endocannabinoid system is central to neurological function. It has been found in several different studies to be an observant regulator of all the body’s different systems and to be involved in epilepsy as well. A disturbance in the functioning of the endocannabinoid system is essentially related to the emergence of epilepsy. During an epileptic seizure, the state of discharge of the resting voltage of neurons can lead to the activation of the endocannabinoid system, and the activation reduces the inflammation of the nervous system. This notion is supported by observations that the amount of endocannabinoids in tissues increases after seizures. (2,3,5)

Endocannabinoids

The amount and quality of endocannabinoids is one factor that seems to vary between a healthy and a sick person, both in epilepsy and in many other diseases. Cannabinoids have been reported to have regulatory properties related to the occurrence and severity of epileptic seizures, which is probably related about the factors affecting the neuroinflammation of the endocannabinoid system .

It seems that the regulation of the rise and fall of the cannabinoid 2-AG is critical for the anti-epileptic effect. 2AG levels and the amount of the enzyme that synthesizes this endocannabinoid are lower in people with epilepsy than in healthy people, but the amount of 2AG has been found to increase immediately after an epileptic attack.

Anandamide levels are also lower in people with epilepsy, which is apparently caused by an increase in the FAAH enzyme that breaks down cannabinoids. CBD acts on anandamide reuptake and increases its amount in the brain while increasing the levels of CB1 receptors. These have been speculated to be part of the antiepileptic effect of CBD. (2,3)

Cannabinoid receptors

The number of cannabinoid receptors is also reduced in epilepsy patients compared to healthy ones. Changes have been noticed e.g. in the hippocampus of the brain. (2) The activation of the endocannabinoid system caused by an epileptic seizure directs the endocannabinoids to respond to the CB1 receptor, which both reduces the inflammatory reaction of the nervous system and mitigates and protects against the damage caused by the seizure (12).

TRPV, serotonin and other receptors affecting epilepsy

The TRPV receptor is not actually a receptor of the endocannabinoid system, but it has its own big role in epilepsy. It is involved in the regulation of seizure and epilepsy and CBD affects the TRPV receptor, sensitizing its functions. CBD has been found to affect the epilepsy-related functions of the TRPV receptor by inhibiting them, but this is still open to interpretation as so little research has been done on the subject.

The serotonin receptor, which is divided into five different classes, is also involved in epilepsy, and CBD has been found to have a good response to the receptors of the serotonin family. It is thought that dysregulation of the 5-HT2 receptor responsible for neurotransmitters in the brain is one of the factors behind epilepsy.

CBD also affects the opioid receptor OR and the GRP55 receptor responsible for regulating neurotransmitters.

CBD seems to affect all of these receptors, calming the neurotransmitters in their nerve connections, and it is thought that part of CBD’s antiepileptic effects arise from this interaction. (5)

Treatment and prevention of epilepsy

Successful treatment of epilepsy is not always simple, and according to the current understanding, it cannot be completely cured. Epilepsy is mainly treated with an individually selected drug, of which there are many different ones available. In one third of the patients, the attacks continue despite drug treatment, one third need more than one drug and one third the drug treatment works well. The best natural treatments are a sufficient amount of sleep, a healthy, varied diet and a life as smooth and stress-free as possible. (1,10)

Especially in situations where the patient has drug-resistant epilepsy, good results have been obtained from the use of CBD oil in all age groups. Epilepsy treatment CBDis not always successful either, and the treatment plan must be made carefully with possible medicines incompatible with CBD. Studies have reported surprisingly high rates of mild side effects, even though the reduction in seizures has been significant and clearly noticeable. It has been speculated that mild side effects such as diarrhea, nausea, intestinal problems, etc. could be treated with transdermal dosing, as the doses used to treat epilepsy are quite large. (5,13)

Since the exact origin of epilepsy is not known, it is difficult to say how it could be prevented. Blows to the head could be prevented by using a helmet in situations where it could be useful and it would be good to avoid heavy alcohol consumption, as it has been found that alcoholics have epileptic seizures other than after heavy blows to the head.

Epilepsy in dogs can also be treated with CBD oil in the same way as in humans.

CBD oil for dog (canine) epilepsy

Epilepsy in dogs is very similar to epilepsy in humans. If no reason for the seizures is found and the seizure does not remain unique, they are always treated as genuine epilepsy. Epilepsy attacks can also be caused by an illness in animals, such as a brain tumor, liver inflammation or metabolic disorders. Genuine epilepsy rarely occurs in old dogs, usually it appears already at 1-5 years of age. (14) Treating dogs with CBD oil has been studied and tried to some extent. In general, about the dosage and use of CBD oil for dogs, you can read more here.

Feline epilepsy is also similar to human epilepsy, but it occurs in percentages slightly more in cats, approx. 3% of cats get a true diagnosis of epilepsy. Even in cats, an epileptic seizure can be a single one, and only when two seizures have occurred within 24 hours, it is started to be examined and possibly treated. (15)

In summary

Few diseases have been around as long as epilepsy. It has remained almost unchanged since the beginning of time, but still no sure working method has been found for its successful treatment or improvement. The quality and intensity of epileptic seizures varies from case to case, but in their main features, epilepsies are similar to each other. The endocannabinoid system also has a strong effect on the background of epilepsy, and CBD oil has had very good results in mitigating or even completely eliminating convulsions.

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