International forskning

Cannabidiol in children with treatment-resistant epilepsy with myoclonic-atonic seizures

Roberto H Caraballo 1, Gabriela Reyes Valenzuela 2, Sebastian Fortini 3, Alberto Espeche 4, Beatriz Gamboni 5, Walter Silva 6, Marco Semprino 7, Lorena Fasulo 7, Santiago Chacón 8, Adolfo Gallo 2, Santiago Galicchio 9, Pedro Cachia 9

  • 1Hospital de Pediatría Prof. Dr. Juan P Garrahan, Buenos Aires, Argentina. Electronic address:
  • 2Hospital de Pediatría Prof. Dr. Juan P Garrahan, Buenos Aires, Argentina.
  • 3Hospital del Niño Jesús, Tucuman, Argentina.
  • 4Hospital Público Materno Infantil, Salta, Argentina.
  • 5Hospital Pediátrico Humberto H Notti, Mendoza, Argentina.
  • 6Hospital Italiano, Buenos Aires, Argentina.
  • 7Clínica San Lucas, Neuquen, Argentina.
  • 8Centro Neurología Infantil “CENI” Gualeguaychú, Argentina.
  • 9Hospital de Niños Victor J Vilela, Rosario, Santa Fé, Argentina.


Purpose: This multicenter study aimed to evaluate the efficacy and tolerability of add-on cannabidiol (CBD) in treatment-resistant patients with epilepsy with myoclonic-atonic seizures (EMAtS) (n = 22) and Sturge Weber syndrome (SWS) with myoclonic-atonic seizures (n = 4).

Methods: Patients who met the diagnostic criteria of treatment-resistant EMAtS or SWS with myoclonic-atonic seizures were included. Cannabidiol was added in doses ranging from 8 to 40 mg/kg/day. Efficacy was assessed by comparing seizure frequency before and after initiating CBD therapy. Neurologic examinations, brain magnetic resonance imaging, repeated prolonged electroencephalography (EEG) and/or video-EEG recordings, and neurometabolic studies were performed in all patients, and genetic investigations in 15.

Results: After a mean follow-up of 19 months, 15/26 patients (57.7%) who received add-on CBD had a >50% seizure decrease; three (11.5%) became seizure-free. The remaining 11 patients (42.3%) had a 25-50% seizure reduction. Drop attacks, including myoclonic-atonic seizures and generalized tonic-clonic seizures, as well as atypical absences and nonconvulsive status epilepticus responded well to CBD. In SWS patients, focal motor seizures without consciousness impairment and focal non-motor seizures with consciousness impairment were recognized in two each; in three a 30% reduction of focal seizures was observed. Side effects were mild and did not lead to CBD discontinuation.

Conclusion: This study evaluating the use of add-on CBD in children with EMAtS or SWS with myoclonic-atonic seizures found that 15/26 (57.7%) had a >50% seizure reduction with good tolerability; three (11.5%) became seizure-free.

Keywords: Cannabidiol; Drop attacks; Epilepsy; Myoclonic-atonic seizures; Sturge Weber syndrome; Treatment-resistant.