Dados do Trabalho
Título
OPTIMIZATION OF SEIZURE CONTROL USING CANNABIDIOL IN A PATIENT WITH LENNOX-GASTAUT SYNDROME
Apresentação do caso
ADS, 18-years-old, suffered from neonatal hypoxic-ischemic syndrome, which later developed into Lennox-Gastaut Syndrome. He presents global developmental delay with significant cognitive deficits and is followed up in an outpatient clinic for refractory epilepsy in childhood. He experiences frequent seizures, including drop attacks, myoclonic seizures, absence seizures, hypertonicity, hyperventilation and head version. In 2016 he underwent a corpus callosotomy and displayed some clinical improvement. He is currently taking multiple drugs, including three benzodiazepines. Additionally, he has autism spectrum disorder and difficult-to-treat insomnia.
Cannabidiol was recently introduced into his prescription resulting in positive outcomes in sleep parameters and seizure control.
Discussão
Lennox-Gastaut Syndrome is a rare form of epilepsy that mainly affects children and adolescents. It is characterized by multiple types of seizures and severe cognitive impairment. ADS case presents a particularly challenging situation due to both the inherent characteristics of the disease and the socio-economic determinants involved. This case highlights the challenge in optimizing seizure control, a typical feature of the syndrome, even when using multiple drugs, as well as the inexorable cognitive impairment that accompanies it. The use of Cannabidiol is still controversial and yet requires additional studies in order to determine it's efficacy in epileptic patients, recommended dose and long-term effects. Nonetheless the compound has shown to be effective as an adjunctive treatment for epileptic patients who do not achieve good control with conventional medications. The introduction of cannabidiol into the patient's therapeutic regimen contributed to decrease seizure frequency and improve his insomnia, resulting in better quality of life for both patient and family.
Comentários finais
This case illustrates the complexity and challenges in treating patients with Lennox-Gastaut Syndrome. These challenges increase as different social determinants are added to the context. It highlights new possibilities for treatment using Cannabidiol, which, although requiring further studies, has emerged as an additional option to conventional therapies in refractory epilepsy. Based on this case, Cannabidiol emerges as a promising principle and new research should be encouraged to achieve improvements in seizure control for patients with Lennox-Gastaut Syndrome.
Palavras Chave
Lennox-Gastaut Syndrome; Cannabidiol; Treatment
Declaração de conflito de interesses de TODOS os autores
Todos os autores declaram ausência de qualquer tipo de conflito de interesses com o trabalho submetido.
Área
Epilepsias
Instituições
Faculdade Atenas - Minas Gerais - Brasil, Faculdade Atenas - Minas Gerais - Brasil, Universidade Federal de Minas Gerais - Minas Gerais - Brasil
Autores
Arthur Barbosa Santos, Maria Eduarda Teixeira Alves, Davi Lucas Ribeiro Rodrigues, Fernanda Castro Soares, Marcelus Henrique Vinhal Andrade, Adoaldo Rodrigues da Silva Filho , Livya Isabella Teles de Oliveira Lima, Thiago Madureira Brandão, Renata Ivanilde da Mata Borges