Cannabidiol in the acute phase of febrile infection-related epilepsy syndrome (FIRES)
Anna Fetta 1 2, Elisa Crotti 3, Elena Campostrini 3, Luca Bergonzini 1 2, Carlo Alberto Cesaroni 2, Francesca Conti 2 4, Veronica Di Pisa 1, Valentina Gentile 1, Maria Cristina Mondardini 5, Cesare Vezzoli 6, Lucio Giordano 3, Duccio Maria Cordelli 1 2
- 1IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell’Età Pediatrica, Member of the ERN EpiCare, Bologna, Italy.
- 2Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, Bologna, Italy.
- 3Child Neuropsychiatric Division, Spedali Civili, Brescia, Italy.
- 4Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
- 5Department of Pediatric Anesthesia and Intensive Care, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
- 6Unit of Pediatric Anesthesia and Intensive Care, Spedali Civili of Brescia, Brescia, Italy.
Affiliationer
Febrile infection-related epilepsy syndrome (FIRES) is a prolonged refractory status epilepticus (SE) that develops among healthy individuals after a febrile infection. FIRES treatment is challenging due to its poor response to antiseizure medications (ASMs) and anesthetic drugs. The use of cannabidiol (CBD) as an adjunctive treatment has been suggested, albeit data about its role in the acute phase is lacking. This report describes the use of purified CBD in the acute phase of two pediatric cases of FIRES and their long-term outcome. Both children were treated with several ASMs, immunomodulators, anesthetics, and nonpharmacological treatment (ketogenic diet). CBD was administered, as an adjunctive treatment, through nasogastric tube about 30 days after onset. SE resolved within 3 days of reaching the target dose and both were seizure-free for 1 year after. Although it is difficult to define the extent to which each previous therapy contributed to recovery, in both cases CBD therapy was a turning point, reinforcing its potential role as add-on treatment in the acute phase of FIRES.
