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Fighting FIRES with Cannabis

The non-psychoactive compound in cannabis, cannabidiol (CBD), has made headlines as a potential treatment for severe epilepsy. A study published this January in the Journal of Child Neurology strengthens the case for CBD, demonstrating its effectiveness in treating Febrile Infection-Related Epilepsy Syndrome (FIRES).

FIRES is a destructive disease that affects young children. Its exact cause is unknown, but it always occurs suddenly following a low-grade fever. On Monday, a historically healthy six-year-old develops an infection. By Friday, he is having nearly continuous seizures.

9 to 18% of children with FIRES do not survive this phase of the illness. Those that do live do not regain their former health. 93% develop chronic epilepsy that is unresponsive to treatment, or refractory. 82% develop cognitive and behavioral impairments that rarely subside.

Treating FIRES with conventional epilepsy medication is fruitless. Even combined at their highest therapeutic doses, antiepileptic drugs offer no relief. Hope for children with FIRES lies in alternative treatments. Dr. Jacqueline S. Gofshteyn at the Children’s Hospital of Philadelphia, along with seven colleagues from other health centers, evaluated CBD as a possible treatment option.

Their study followed seven children diagnosed with FIRES ranging from ages three to eight. Their home health centers, the Children’s Hospital of Philadelphia, Texas Children’s Hospital, NYU Medical Center, Ann and Robert H. Lurie Children’s Hospital of Chicago, and the University of Iowa, provided the CBD treatment.

The children were unresponsive to conventional epilepsy medication, each taking an average 7.1 different drugs to no avail. Each had tried alternative treatments with similar success. The CBD study offered one treatment no child had tried. They were prescribed Epidiolex, an oil-based CBD extract, on top of their normal treatment regimens.

Two children received CBD in the earliest stage of FIRES. One child went from having hundreds of seizures a day to having none for a month. Seizures later returned but in low frequency. Unfortunately, the second child passed away following prolonged anesthetic treatment. Prior to that, however, the child’s seizures had improved, only occurring in response to specific stimuli.

The other five children received treatment in the chronic phase of FIRES. Four weeks in, the frequency of their seizures had decreased by an average 90.9%. Specific seizure types were reduced even more dramatically. The children’s most common seizure type, known as a “dyscognitive seizure,” was reduced by a whopping 99.6%.

By 48 weeks, CBD’s effects dwindled slightly. As compared to 90.9%, the children had 71.8% fewer seizures. However, their overall prognoses had improved. Five only had focal seizures, isolated to one area of the brain. Their cognitive and motor function improved, with four able to communicate verbally, four to walk independently, and one to walk with assistance. Most significantly, all children were weaned off their other medications, taking an average 2.8 antiepileptic drugs rather than a daunting 7.1.

Though limited, this study makes a strong case for fighting FIRES with cannabis. Future research will solidify if CBD is the alternative treatment these children so desperately need.

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