How Medical Marijuana Can Help Seizure Patients in Arkansas

DISCLAIMER: This guide is provided for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. Consult your doctor before starting any new treatment, including medicinal marijuana. Results vary, and medical marijuana may not be right for everyone.

Seizures and epilepsy affect approximately 3.4 million Americans, with roughly 470,000 children living with the condition. About 30% of people with epilepsy have treatment-resistant or drug-resistant epilepsy, despite trying multiple medications.

Arkansas allows people with seizures and epilepsy to use medicinal marijuana. New studies, such as the FDA’s approval of cannabidiol (CBD) for some types of epilepsy, demonstrate that cannabis may help people who haven’t been able to control their seizures with traditional medicines.

Seizure and Epilepsy Causes

Seizures occur when abnormal electrical activity disrupts normal brain function. Epilepsy is diagnosed when someone has two or more unprovoked seizures.

• Genetic factors: Inherited epilepsy syndromes with specific gene mutations affecting neuronal function
• Brain injuries: Traumatic brain injury, stroke, or infections like meningitis and encephalitis
• Structural abnormalities: Brain tumors, malformations present from birth, or scarring from previous injuries
• Metabolic disorders: Conditions affecting blood sugar, electrolytes, or other metabolic processes
• Developmental disorders: Conditions like autism spectrum disorder or neurofibromatosis
• Idiopathic epilepsy: No identifiable cause (accounts for about 50% of cases)

Symptoms and Health Effects

Seizure Types and Symptoms

Generalized seizures (affecting both sides of the brain):

• Tonic-clonic (grand mal): Loss of consciousness, muscle stiffening, rhythmic jerking
• Absence: Brief lapses in awareness, staring spells
• Myoclonic: Sudden, brief muscle jerks
• Atonic: Sudden loss of muscle tone, causing falls

Focal seizures (beginning in one area):

• With retained awareness: Unusual sensations, emotions, or movements while conscious
• With impaired awareness: Confusion, automatic behaviors, altered consciousness

Health Effects

• Cognitive impacts: Memory difficulties, concentration problems
• Psychological effects: Anxiety about seizure occurrence, depression, and social isolation
• Physical risks: Injury during seizures, drowning risk, SUDEP (sudden unexpected death in epilepsy)
• Quality of life: Limitations on driving, employment, and independence
• Sleep disruption: Nocturnal seizures, medication effects on sleep

Diagnosis

• Clinical evaluation: Detailed seizure history, neurological examination
• Electroencephalogram (EEG): Records electrical brain activity to identify seizure patterns
• Video EEG monitoring: Captures seizures on video while recording brain activity
• Brain imaging: MRI or CT scans to identify structural abnormalities
• Blood tests: Rule out metabolic causes
• Genetic testing: For suspected inherited epilepsy syndromes

Prognosis

• Seizure control: About 70% of patients achieve seizure freedom with appropriate treatment
• Treatment-resistant epilepsy: Approximately 30% continue experiencing seizures despite multiple medications
• Life expectancy: Generally normal with proper management, though SUDEP risk exists
• Remission potential: Some epilepsy types, particularly childhood forms, may go into remission
• Quality of life: Varies significantly based on seizure control and treatment side effects

Seizure Treatments

First-Line Treatments

Anti-epileptic drugs (AEDs):

• Sodium channel blockers: Carbamazepine, phenytoin, lamotrigine, oxcarbazepine
• GABA enhancers: Valproic acid, gabapentin, vigabatrin
• Broad-spectrum agents: Levetiracetam, topiramate, zonisamide
• Calcium channel modulators: Ethosuximide (for absence seizures)

Treatment approach involves:

• Starting with a single medication (monotherapy)
• Adjusting dosage based on seizure control and tolerability
• Trying different medications or combinations if initial treatment fails
• Regular monitoring of blood levels and liver function for certain medications

Other Treatments

Epilepsy surgery:

• Resective surgery: Removing seizure-generating brain tissue
• Corpus callosotomy: Severing connections between brain hemispheres
• Lesionectomy: Removing specific lesions causing seizures
• Hemispherectomy: For severe cases affecting one hemisphere

Neurostimulation devices:

• Vagus nerve stimulation (VNS): Implanted device stimulating vagus nerve
• Responsive neurostimulation (RNS): Detects and interrupts abnormal electrical activity
• Deep brain stimulation (DBS): Targets specific brain structures

Dietary therapies:

• Ketogenic diet: High-fat, low-carbohydrate eating plan
• Modified Atkins diet: Less restrictive version of ketogenic diet
• Low-glycemic index treatment: Focuses on carbohydrate quality

Alternative & Complementary Approaches

• Stress management: Meditation, yoga, biofeedback
• Sleep hygiene: Consistent sleep schedules, avoiding sleep deprivation
• Trigger avoidance: Identifying and avoiding personal seizure triggers
• Nutritional supplements: Magnesium, vitamin B6, vitamin E (discuss with healthcare provider)
• Acupuncture: Some patients report benefits, though research is limited

Cannabis for Seizures

CBD influences seizure activity through multiple pathways:

• Endocannabinoid system modulation: Inhibits FAAH enzyme, increasing anandamide levels
• Receptor interactions: Affects 5-HT1A serotonin receptors, TRPV1 receptors, and GPR55
• Neuronal stabilization: Balances excitatory and inhibitory neurotransmission
• Anti-inflammatory effects: May reduce neuroinflammation contributing to seizures
• Neuroprotective properties: Potentially protects neurons from damage

Clinical Evidence

Dravet syndrome trial (New England Journal of Medicine):

• 120 children and young adults enrolled
• 39% reduction in convulsive seizure frequency with CBD vs. 13% with placebo
• Median decrease from 12.4 to 5.9 seizures per month
• 3 patients achieved complete seizure freedom

Lennox-Gastaut syndrome trials:

• Significant reduction in drop seizures with CBD treatment
• Improvements in overall seizure frequency
• Benefits maintained in long-term extension studies

Broader drug-resistant epilepsy:

• 35-63% of patients achieve ≥50% seizure reduction
• Real-world studies show similar results to clinical trials
• Some patients achieve complete seizure freedom

FDA approval

In 2018, the FDA approved Epidiolex® (pharmaceutical-grade CBD) for:

• Dravet syndrome (ages 2+)
• Lennox-Gastaut syndrome (ages 2+)
• Tuberous sclerosis complex (ages 2+)

This marked the first FDA approval of a plant-derived cannabis medication.

Cannabis Compounds for Seizures

Cannabinoids and terpenes of particular interest for epilepsy include:

Cannabinoids:

• CBD: Primary anticonvulsant cannabinoid
• CBDV (cannabidivarin): Emerging research suggests anticonvulsant properties
• THC: May provide additional benefits for some patients, though less studied
• THCV (tetrahydrocannabivarin): Potential anticonvulsant effects

Terpenes:

• Linalool: Calming effects, may support seizure management
• Beta-caryophyllene: Anti-inflammatory properties
• Myrcene: Sedative effects, may improve sleep
• Pinene: Anti-inflammatory, neuroprotective potential

The “entourage effect” suggests whole-plant products containing multiple cannabinoids and terpenes may be more effective than isolated compounds for some patients.

How to Register for an Arkansas Medical Marijuana Card

• Register with TeleLeaf
• Connect with a doctor online
• Connect with one of our licensed doctors to receive your legal recommendation.
• Register online with the Arkansas State Medical Marijuana System Medical Marijuana Program. Please note you will need your completed physician-written certification from the doctor to complete this step in the process.
• Print a copy of your card. Patients who apply online can print a copy of their cards after their applications are reviewed and approved.
• A physical card will be mailed automatically to you once your application has been approved. Processing time is up to 14 days from the date we receive your application and payment.
• Access medicine at any of the licensed state dispensaries using your card. A full list of Arkansas dispensaries can be found here.

Integration with Existing Treatment

Critical considerations:

• Never discontinue anti-epileptic medications without medical supervision
• Medical marijuana typically used as adjunctive (add-on) therapy
• Potential drug interactions require monitoring
• Coordinate care among neurologist, certifying physician, and pharmacist
• Track seizure frequency, duration, and any changes in patterns

Additional information for patients

• Medical supervision: Essential for safe, effective use alongside conventional treatments
• Medication interactions: CBD can affect metabolism of certain AEDs; blood level monitoring may be needed
• Individualized approach: Response varies; treatment plans should be personalized
• Documentation: Keep detailed seizure diary to assess treatment effectiveness
• Lifestyle factors: Adequate sleep, stress management, trigger avoidance remain important
• Support resources: Epilepsy Foundation (www.epilepsy.com), Epilepsy Foundation of Arkansas

Take the Next Step With Teleleaf

Arkansas’s Medical Marijuana Program provides legal access to cannabis-based therapies for qualifying patients with seizures and epilepsy.

Visit www.teleleaf.com to schedule your consultation and explore whether medical marijuana may benefit your seizure management plan.