Seizures

#009: Role of Cannabinoids in Seizure Disorder — Part 1

The Ancient Greeks believed that seizures and epilepsies were a curse from the gods, but today we understand a little bit more about how the body really works. In today’s episode, I talk about what epilepsy is, what a seizure is, and some of the ways we can treat seizures.

A seizure is an increase or surge in the electrical activities in the brain. If you have one seizure, then you just have had a seizure. If you have recurring seizures, then that’s epilepsy. The difference between the two is important because it may impact how you are treated by a doctor.

There are many possible causes for seizure, including:

  • Brain tumors
  • Cancer
  • Brain injury
  • Stroke
  • Or a genetic disorder or defect.

While some people might have a little warning before a seizure, like maybe an aura, most have no symptoms. This has a serious impact on their life because they could be driving or at school, and then they suddenly drop to the ground. It can be scary and depressing to have such a sudden thing come on you all at once.

I talk about different kinds of seizure-like absence, simple partial, and tonic, and what they look like. In order to correctly treat a seizure, it is very important for a doctor to understand what kind of seizure it is. I discuss how to help someone who is having a seizure, and some of the side effects of a seizure, including loss of bladder control or bowel control.

In the next episode, I will talk about some of the ways we could use cannabinoids in seizure management, and why we must treat women’s seizure symptoms differently than men’s. You do not want to miss part two.

What’s Inside:​

  • I talk about focal and generalized seizures and what those are.
  • What the side effects of seizures or epilepsy are.
  • I describe a simple partial seizure and an absence seizure.
  • What you should do if your child has a seizure.
  • How to manage a seizure, with both pharmacological and non-pharmacological means.

Mentioned In This Episode:

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Transcription:

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TRANSCRIPT

Hi, guys. Welcome to another episode of Let’s Talk About Medical Cannabis with Doctor O. My name is Lola Ohonba, a clinical pharmacist certified in medical cannabis. I’m very appreciative that you could join me today. Thank you so much for all our listeners, how they appreciate your support. Thank you again to our subscribers. If you already subscribe to the show, I would like to say thank you. For those of you that are yet to subscribe. You can now have access to the show on our website. Direct access is now available on our website so that WCI-Health. You will have direct access to the episode and also like to say thank you to Patreons. All these patreons are supporting us financially. I would like to say thank you for your support.

And if you want to join the Patreon, you want to support the show. There is also a link on our website under the subscribe page. You will see a link to these podcast platforms. A link is also there for the Patreon, if you want to join our Patreon group. Thank you guys so much. Onto this show, I will be discussing a role of cannabinoids in epilepsy or seizure disorder. The role of cannabinoid in epilepsy or seizure disorder. What is epilepsy? What does epilepsy mean? What is the meaning of seizure? Back in the days in the age of the Greek Gods it was said that diseases were caused by the gods. They believed that when people do something that is wrong or bad things, then the gods would place a curse on people back in the day. So that’s why people get sick. So is there really a cause? Is disease really a cause from God? Will we be looking into that today? Will we also look into the role of medication, pharmaceuticals? Pharmaceutics ward? They play the role they play in the management of a seizure disorder. We will look into various form of seizure disorder.

We will finally look at the role cannabis can play in the management of seizure disorder. So glad you could hear me. So glad you could join me today. Thank you so much. So like I said earlier, the ancient Greeks, they believed that diseases are a result of demonic cause plays on a human by the gods whenever people did something wrong. That is really what I call hocus pocus. Hocus pocus, a deliberate, mysterious nonsense.

That is hocus pocus. I mean, it’s really not only in our generation that we see all this hocus pocus. It’s been around for a generation and it seems very funny. Conspiracy theorists have existed, not just in our generation, I guess it’s been from the inception of man. We’ve had conspiracy theories is very, very funny. Oh, according to the Greek historians that they, Seline, the goddess of the moon.

Wonder why she’s mad with people. Should we just invoke a curse? And part of the cause she used to evoke was a seizure or epilepsy.

I guess we could say that not only Queen of Soul Aretha Franklin wasn’t the only one that demanded respect during a night in my life, man.

I’ve been demanding R-E-S-P-E-C-T.

And I guess the goddess of the moon Seline didn’t just demand it, she enforced it on or made sure people gave that R-E-S-P-E-C-T. It’s very often women, we women and girls, we are female. Generally, we are not. Just so we didn’t just that being diva, having a device attitude to in this generation diva like attitude was this way way back. And it was obviously presented in point, a goddess of the moon Seline. I mean, it’s an idea and we gotta have that respect, you know? So it’s a really funny situation. If you don’t respect me, I will put a curse for you, huh?

Oh, Lord, I know we have.

According to a historian, the Greek historian the Hippocrates of Kos. He was a Greek physician, he was the day Greek physician, he was known as the father of medicine. He was the first person that came out and said diseases were not curses from God. That diseases were due to human.

So Hippocrates of Kos. He was the first to debunk these demonic conspiracy. He said that the diseases were not as a result of curses from God that diseases we are due to human body reacting to substances in the environment. In his work that is tattooed on the sacred disease. Hippocrates of Kos claimed the epilepsy is a disease due to brain disorder and not due to divine rage.

At least we have that it’s not just depressed. Trying to debunk conspiracy is not just our own the new generation press trying to debunk conspiracy.

Hippocrates of Kos was one of the first press that we had to call it as he sees it. He basically came out and said, no, you all need to stop.  This disease is not a curse from the gods. Disease is a result of environmental factors, among other things. So today, what we’ll be looking into epilepsy, epilepsy seizure disorder. Seizure is a part of epilepsy. They’re both on the same team.

But epilepsy is like a continuation of the spasm of the symptoms of seizure. When you have it one time, we can call it a seizure, but when it’s continuous. The technical terms would be epilepsy. So what is epilepsy or what is seizure disorder? Seizure disorder is said to be the fourth most common neurological disorder.

Epilepsy is a brain disorder that causes people to experience unpredictable and recurrent seizure. So basically epilepsy, when you have epilepsy, you have a recurrent seizure. If you have one seizure episode, you won’t call it epilepsy. But when the seizure episode is repeating itself then we name it epilepsy. Seizure disorder, seizure is due to increase in or surge in electrical activities in the brain. Our brain works on electric function. It’s an electric organ.

So when they saw an increase in the brain activity. This can lead to violent muscle spasm, uncontrollable bowel movement, loss of consciousness, among other things, so basically a seizure. This was a manifest itself in different symptoms. It could be loss of consciousness. There could be muscle spasm. There could be loss of bowel movement. There could be rigidity. So a seizure. It comes in different manifestations like that.

But the main reason we don’t really know is probably due to dysfunction in the brain electrical activities. So what is the cause of this disease? What causes seizure? I’m sure everybody wants to know that.

The real cause of the disease is unknown, but it could be due to severe brain injury. It could be due to tumor, cancer, growing brain tumor, stroke, or it could also be due to genetic disorder. So what is actually causing it that we don’t have or pinpoint what it is? But it’s been said to probably be due to some kind of brain injury.

It could be due to cancer, brain cancer, strokes or other genetic disorder or genetic defect in the DNA. Over 3 million Americans are affected by some form of seizure disorder. And this may also include children. There is no cure for a seizure. We don’t have a cure, but we can use medication to manage these symptoms of the episode itself under control. But when we say, Oh we have cured it. There’s really no cure for for this disease. So what we have for the management of seizure is medication.

But unfortunately, a lot of this anti-seizure medication, it tends to have adverse side effect. The really bad side effect that sometimes makes people noncompliant with the medication. And basically, people stop taking their medication due to side effects. Sometimes people can start adding weight. There are so many side effects that people are unable to to control it.

Also, apart from people having side effects from the medication. Some of the medication that are used. The medications that are available, some people, up to a third of the population suffering from seizure disorder, it’s non effective for them. So we have people that don’t take their meds saying because of side effect and some people the medicine available doesn’t even work for them. So when we have this situation, where do we go?

How do we manage people that are not responding to traditional medication? We’ll look into that. Seizure disorder or epilepsy, if it’s not controlled or managed, it can have a really devastating impact in people’s life because they the episode always happens suddenly. Some people might have what we call a little aura. They might have a sign. But most people don’t have a sign when seizure disorder is happening. It’s a sudden process. Somebody can just drop by shaking suddenly.

So because of the sudden nature of this, it affects people’s way of life. It could affect schools for children. It could affect a walk or meanwhile could be driving and the whole situation starts, that could lead to death.

So it’s a very, very serious situation that, if not managed, can be devastating to the family. For me, I have experienced this situation. Two of my kids, they have different types of seizure disorder. For my son when the situation first started with him,

It just happened. It was after a Thanksgiving holiday. The day after the Thanksgiving we were just talking to him and suddenly started just looking funny I know we were like, what’s going on? What’s going on with you? And the next thing we see, he was going down. Thank God somebody was close to him. We had to quickly grab him because we were in my kitchen. We have tile floor.

If he had dropped down like that, he could have really injured himself really bad. So the sudden nature of this disease makes it an emergency for us to be able to look for ways to manage the disease. So what other types of seizure disorder do we have?

The first one we I’m going to be talking about today is focal or generalized seizure. In focal or generalized seizure, we can also divide it. It also has a solved division. So it is one affair. It’s one area of the brain. I mean, it makes sense when you see focal or you’re focusing on one thing. So in focal seizure we have one area of the brain that is affected. It can come in some form of those simple, partial seizure.

In simple, partial seizure, there’s no loss of consciousness. It could be a result in spazzing vision or emotional changes. So in a simple partial seizure, you, an individual suffering from this episode, do not lose the consciousness. But he could, this seizure could affect the vision could affect the emotion. It could also resort in spasm but it doesn’t result in loss of consciousness. Then we also have a complex partial seizure. In complex partial seizure, this involves loss of consciousness. So this is a little bit step up in, compared to those simple partial seizure in the complex, there is loss of consciousness. The person suffering from this disorder can experience some kind of staring in space is sadly a state of unaware of the surrounding and they can also have a repetition fashion. Such as they can be walking in a circle and they’ll be staring into space and they can also lose consciousness.

So the other main type of seizure disorder is the what we call a generalized seizure disorder. Under the generalized type, we have the one we call absence seizure.

The absence seizure is common in children. Often is characterized by staring into space, slight body movement or eye blinking tweaking could result in loss of consciousness.

So in the absence seizure, the child is all mostly common in children and daily life. There a in space. And like I said, my family, we have, my kids have experienced one form of this disorder or the other. My other son had an episode in when he was little in the daycare where they said after they came back from a field trip and they sat down, he was just staring and he wasn’t moving, he was just staring. And the next thing they knew, he just fell down.  So they had to grab him. That was during the summer time. Another time in the winter, the same thing happened to him. And so children are very susceptible to absence type of seizure disorder.

So apart from the absence, under the generalized tab, we also have the tonic. In the tonic situation, the muscles stiffens. It’s a muscle stiffening, like the muscle, back muscle. The arms and the legs are mostly the part that are affected in the tonic. This could result in a fall. Somebody can fall when the muscles stiffen up, so the individual going through this process can fall apart from tonic. We also have the tonic. In the tonic situation, this is called a drop seizure. Basically, there is no movement. In tonic they don’t have muscle. You just drop. So individual will just fall to the ground suddenly.

And in the other one that we have on that, a generalized seizure is the clonic. The clonic is characterized by repetitive muscle jerking.Jerking is like your muscle is just jerking. And the symptoms are kind of similar in most of the disorder but you have to specifically know about the disease, you have to be a professional to be able to differentiate which one is going on. So in the clonic type, there is a repetitive jerking muscle, jerking, which are felt mostly the neck the face or the arms. Other than the clonic. We have these mild clonic. In the mild clonic type of seizure disorder. There’s a brief or jerk or twitching of the arms on the legs. This part is in the clonic it affects most in the neck. In the mild clonic, it affects the arms and the legs. So apart from that, we also have a tonic clonic seizure disorder. In the tonic clonic episode, this is the most severe of all the generalized seizure disorder.

The individual loses consciousness. They’re shaking, there’s stiffness. It could also result in a loss of blood. I think that’s the most, the one we tend to notice the most because it has more reaction going on while the other ones, they can be very dangerous because you don’t really notice the signs. Like in the absence seizure, you just, a child is just staring. You might think the child is just staring, or you might think the child is just trying to be quiet and not knowing that the child is going through a process. But that is not the case with tonic clonic. In the tonic clonic there is that characteristic shaking movement of the muscle. There is stiffness and it could result in loss of bladder. As a parent who has experienced a child going through a seizure disorder, this can be very, very scary. So any individual, especially when it’s a child, that is going through this episode. Individuals that are present need to try to stay calm. It’s hard to be calm when you see somebody going through this process. But we have to try to to remain calm. Depending on where it’s happening, if anybody is around a child that is having a seizure, just try to calmly put them on a floor. Don’t try to force them or let them be calm because they will try to go through the episode while you call an emergency line 911. So they can the professionals can come in and take care of the situation.

Part of the emotional side effect that people experience when they are going through a seizure. or even a family member. Part of the emotional stress that comes with it is depression. People can become depressed. Anxiety is part of what people go through and it will make sense. You know, I mean, when you see your loved ones going through this situation is very tough. You don’t know where it’s gonna happen. You don’t know when it’s going to happen. Imagine somebody driving and having a seizure. So you see a very, very tough situation. And people, the embarrassment that comes with it, this can have an emotional toll on an individual and a family member still. Apart from the emotional stress that comes with this disease there are other life-threatening situations that can be seen.

An example of those life-threatening situation is this what we call the status epilepticus. Most time seizure when it happens, it happens for a short time and the person becomes calm. But in the case of a status epilepticus, this is a continuous seizure activity beyond five minutes without regaining consciousness. So basically, the individual is going through the seizure. It could be loss of consciousness. And they did not come back. They did not wake up four to five minutes or more. If the situation continues it could lead to brain damage because see, when somebody loses consciousness, they’re not breathing. And when you are not breathing, whatever activities is going on in this disorder is going on in the brain. So your brain is already susceptible to danger coming from the seizure and you are not breathing. So if you are not conscious within a short time, this could lead to brain damage. So status epilepticus any seizure days beyond five minutes, that is a medical emergency.

And the individual going through this process needs to be taken into the hospital and be treated as anemergency situation. The other life-threatening situation that can happen is what we call sudden, unexpected death in epilepsy. SUDEP is called an acronym for a sudden unexpected death in epilepsy is what we call SUDEP. The cause of SUDEP is unknown because some people said it could be due to cardiac or respiratory condition. The uncontrolled seizure can result in SUDEP. So SUDEP is the situation. Because of it, nobody knows but it’s as a result of a complication from that they assume might be due to cardiac or arrest story complications resulting from seizure disorder. So for people that have seizure, it also have to be managed and controlled. But if it’s not controlled, it could lead to sudden death.

That is why we have to do whatever it takes to make sure people get medication that they need or the treatment that it needed to manage this disorder. So it also become very important in a situation where somebody is going through a seizure. If they are not compliant with your medication, this could lead to a SUDEP. So we have to make sure people are taking care of.

So how do we manage a seizure. Like I said, we have the non-pharmacological way of managing it. We have the pharmacological way of managing it as well. So how do we manage a seizure disorder? The non-pharmacological ways of managing it is a diet. Like I always says, we have to start from the lowest of the therapy and try non-pharmacological way for not just for seizure disorder, for all diseases. After we try the non-pharmacological way. If it’s not working, then we can now go onto the medication.

And when we do medication, when we are to go through the round of medication, we have to start slow. We have to go slow. We don’t want to say, oh, is a major seizure. We gonna give them two medication at the same time. No, we normally start low start with a low dose with one agent. Then we assess the situation as it goes along. So for non-pharmacological means of, three things are seizure disorder. Some people have tried a special diet that they claim helps with seizure. Some studies have shown the ketogenic diet is effective in reducing the number of seizure episodes in people taking this food.

So what is Keto diet for? It focuses on protein diet. I will go into detail about that later. Apart from diet, the people have also used surgery. When you try diet, of course, surgery is gonna be the second line of therapy. Surgery will probably be the last line of the non-pharmacological. Therapy is being tried on pharmacological therapy. It’s been tried. When I say pharmacological, I’m just talking about medication.

But surgery is a non-pharmacological way of managing the disease. So what do they do? What they do with surgeries is an implant called the vagus nerve simulator that may help some people. So they implant what we call our vagus nerve simulator into the individual. So after we have tried the non-pharmacological way of controlling it and it’s not working, then we absolutely need to try medication. Drug use in the treatment of seizure. They vary depending on the type of seizure or the severity of the seizure disorder. The symptoms, the frequency of the episode. So the drug that is used, it varies. But some of the commonly use drugs. Those ones they include the carbamazepine. Recall, we have phenobarbital. We have the Lamictal, which is the Lhamo. We are the topamas which is the topiramate. We are fanning Toyin. We are valproic acid. We have a keppra, which is the liverterositin We have the Lyrica. That’s probably common, which is called pre-gabulin. And in all this drugs, they might have different names that is called outside the United States. But these are prescription medication that have to be the prescription has to be issued by the primary doctor and this will be filled. Most of the disorder, the seizure types.

The common drugs that are used are similar, but it is just the combination of the product that is different. Like if it’s a partial seizure, they can use a particular agent. If it’s like absence seizure, or tonic clonic, they can decide to use another type of agent. But at the end of the day it’s just variation in the combination. Most of the time the provider would generally choose an agent to use based on clinical guidelines. They are guidelines have been set up by the FDA, by the body that is in charge of each disease’s stage. Every disease or condition, they have a guideline based on that association’s process. So the doctor will go through the guidelines and choose the specific agent that he or she feels will be helpful for for the patient. So we have to take anybody going through this episode to the provider to take care of this situation. I know sometimes when you see these things you feel like, oh, my God is probably gonna be a pass. Most times when it’s only one episode, when the seizure is just one episode they might not really treat it with pharmacological therapy, but when it’s starts getting into two episode, the medication has to be used to control the disorder.

So this will be the end of our part one of this episode today. On our next episode, I will look into the role of cannabinoid, the role of cannabinoid in management for seizure disorder. I will also look at the agent the FDA approve cannabinoid-based products. We have some FDA approved medications that are based on cannabis. So I will look into that and we will also look on to the different ways that see we treat women and females. Generally, the different way we treatfemales when it comes to seizure disorder. Where men are different from women when we look at seizure disorder, because females, they have hormonal situation and when she gets pregnant when during pregnancy. The way we will treat a pregnant lady is different from the way we will treat a man. So on the next, on episode two of this topic, we will look into all that. You absolutely, definitely don’t want or miss that part of it.

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