Epilepsy

Epilepsy is a chronic neurological disorder defined by an enduring predisposition to generate unprovoked seizures, encompassing focal, generalized, and developmental-and-epileptic-encephalopathy syndromes. At the time of the NASEM (2017) review, evidence for cannabinoids in epilepsy was rated insufficient/limited—though in practice this has been effectively strengthened by subsequent regulatory action. In June 2018, the FDA approved highly purified cannabidiol oral solution (Epidiolex; GW Pharmaceuticals) for Dravet and Lennox-Gastaut syndromes in patients ≥2 years, later extended to tuberous sclerosis complex (2020). Pivotal randomized trials by Devinsky and colleagues (NEJM 2017, 2018) and Thiele and colleagues (Lancet 2018) established efficacy for these syndromes. The Stockings et al. systematic review (J Neurol Neurosurg Psychiatry 2018) supported CBD efficacy for treatment-resistant epilepsies. Evidence for other epilepsy types remains limited. → See also: Epidiolex, CBD, Dravet syndrome, Lennox-Gastaut syndrome.