Seizures & Convulsion Disorders
Seizures and Convulsion Disorders
Written by: Cami Crane
Though these two terms may be used along side each other or some even use them as the same terms, they are different. A seizure can happen without a convulsion, as a convulsion is the rapid movements and uncontrollable shaking. The convulsions make it very obvious that someone is suffering from a fit, but not all seizures are so recognizable. Which makes it very important to have someone with you that fully understands your ailment, or even a service animal to keep you safe in times that you are suffering from a fit. A single type of seizure can have multiple different types of ailments attached to it.
Because there are so many types of seizures it is important to fully understand what you are affected by, how the seizure is affecting your brain, and how your brain is making your body react. The goal with this as with any ailment to to take preventative measures so that you can accomplish longer lengths of time without suffering from any fits. Natural medicine I feel is the best route to go, you will be making the least of an impact on your body and mind. Pharmaceuticals can be very mind altering, and very harsh on your kidneys and liver as it has to process these man made chemicals.
We are going to go through a breakdown of each type of seizure so that you can effectively understand how to treat a fit, and move into the preventative measures using cannabis based on how you feel most comfortable and what works for you best.
Absence Seizures or Petit Mal Seizures
These seizures can be very hard to spot, they can be very short lasting between 5-30 seconds but usually more than 10 seconds, these seizures end very abruptly, the individual usually returns to their normal self very quickly. If there are convulsions linked to these seizures they are very light, consisting of; eye movements, frequent blinking, jerking lip movements, head nodding back and forth, or the head may drop to one side, individual may drop anything in their hands, in severe rare cases the person may fall. Some of the other symptoms and signs consist of; blank staring, being unresponsive, struggling communicating, making noises such as grunting to try and communicate.
To find the cause of these seizures the doctors will generally start with an MRI to rule out any other causes such as a tumor or stroke. When these two factors have been ruled out there is a 24 hour electroencephalogram test, where they try and provoke hyperventilating to trigger a fit, and monitor afterwards to find an average of how many times in that 24 hour period you have episodes. An individual is generally diagnosed between the age of 4-10 but has a higher chance of diagnosis between the age of 5-7, many of the children that have been diagnosed have a genetic predisposition.
On average 25% of people diagnosed with epileptic absence seizures are misdiagnosed, and have an underlying mental ailment. This can be very frustrating and difficult to understand and treat. 30% of people that have these absence seizures are suffering from something called psychogenic non-epileptic seizures or PNES, which can branch off of and underlying psychological or emotional cause like depression, post-traumatic stress disorder, cardiac disease, chronic pain, chronic illnesses, anxiety, the list goes on. This makes me question the misdiagnosis because if hyperventilation is 90% of the time a trigger, that is a psychological trigger that can be linked to anxiety, depression, schizophrenia, bipolar disorder, and many many more.
These seizures consist of brief involuntary jerking of the muscles, after a myoclonic seizure the individual will fairly quickly go back to what they are doing. These fits do not require medical attention they generally affect the upper body; arms, face, shoulders, neck. These can be paired with other types of seizures, these are much more serious. Though these generally affect the upper body it is very common for people to experience leg cramps and spasms at night. Many of the disorders that have these types of seizures can not be cured but have been controlled with medication. I am very against pharmaceuticals but I always tell people to not cut their medications cold turkey, but instead slowly themselves on to the CBD and if they choose and properly advised by their doctor off of their medications to begin with the precautionary measures so that they can be proactive in preventing further fits. Some doctors may advise against this, simply because they don’t understand the effects. So if you are serious about moving to a more natural way of treating your ailments, I would recommend looking into multiple doctors to see how they feel about changing anything over from your. One of the main diseases that consists of myoclonic seizures is going to be Juvenile Myoclonic Epilepsy or JME this is a genetic disorder, but can occur without having a history of it in their family. 17- 49% of those diagnosed have a history of it in their family. This also goes for Teenage epilepsy, this is going to attack the central nervous system, and can cause the loss of consciousness along with seizures.
A few other things that can cause these myoclonic movements are going to be; hypoxia, which would mean that the individual did not receive enough oxygen at birth, kernicterus, an excess amount of a pigment Called bilirubin which is produced by the liver, or cerebral palsy, which is a neurological disorder.
This is going to consist of tightening and relaxing muscles repeatedly, this can last a few seconds to a minute, when a clonic seizure is not combined with anything else. Though a clonic seizure is extremely rare and generally occur with babies. There are two types of clonic seizures one affects one side of the brain referred to as a focal clonic seizures this would affect one side or part of the body or face, and the person may be fully aware and conscious during their fit. The second type is going to be called a generalized clonic seizure this is going to affect both sides of the brain and causes jerking movements to the whole body at once. The generalized clonic seizure the person is usually not aware and will most likely fall if they are standing. A focal clonic seizure can affect not only the motor part of the brain causing the jerking movements but it can also affect the sensory part of the brain causing tingling and numbness. If the individual has suffered a focal clonic seizure, and they were fully aware during it they should be able to return to what they were doing before hand fairly quickly as they remained fully aware. Suffering from a generalized clonic seizure that affects the whole brain or going into a clonic-tonic seizure the person may need some rest before returning to usual activity.
These seizures can affect people of all ages, including babies and may go away on their own upon growth, if the seizures do not dissipate on their own they will require a long-term treatment plan. One of the most important things is going to be mixing sure that the person is remaining safe during this time but do not try and restrain them. There are some jerking movements that can be mistaken for a clonic seizure in infants mostly during crying, an infant will be more alert if they are just experiencing jitteriness versus having a clonic seizure but it is possible to find out exactly what is going on based off of an electroencephalograph. Which would read the brain over a 24 hour period, and allow doctors to assess what is going on when these symptoms occur.
These types of seizures are going to cause a certain muscle area to tense up or the whole body to tense up depending on the type of tonic seizure it is, there are going to be two types of seizures with this as well again being referred to as focal or generalized based on what parts of the brain are going to be affected. Focal being one part of the brain, causing a muscle group or small part of the body to tense up. The generalized, is going to be the whole brain and will affect the whole body and can cause the person to fall. These seizures are generally fairly short and last no longer than 20 seconds. These are most commonly seen alongside another type of seizure. A person will only need first aid when they are not fully aware during their seizure, generally only a generalized tonic seizure, when their whole brain has been affected, in turn affecting their whole body.
This is going to be the proper term for Grand Mal Seizures, these tend to be some of the more dramatic of seizures as they come in different phases the first phase will be the tonic phase causing stiffening of muscles, falling to the floor, air will be forced past the vocal cords causing crying, the individual may bite their tongue or cheeks causing their saliva to be filled with blood. When the second phase starts, the clonic phase, arms and legs will begin to jerk rapidly, after a few minutes the jerking will slow and stop. After a tonic-clonic seizure the person may look blue and dim if they struggled breathing during the fit. Upon returning consciousness and awareness the individual may be lethargic, irritable, confused, sleepy, or depressed. These clonic-tonic seizure generally last about 1-3 minutes, if they last longer than 5 minutes the individual needs immediate medical attention and 911 should be contacted as soon as possible. In the rare case that a seizure lasts longer than 10 minutes, or if there are 3 consecutive seizures without the person regaining awareness between them they are considered status epilepticus, and emergency treatment in a hospital is needed immediately, as this is an extremely dangerous state.
The action that causes this reaction is going to be episodes of irregular electrical activity in the brain, this can be caused by a few different things. Not only can this be hereditary, but can also be caused be a brain injury; stroke, trauma, brain tumor, infection. Low oxygen at birth can also be a factor, other triggers can be as simple as low blood sugar or high fever. Since there are so many different factors that can lead to an episode the frequency can vary from once in a lifetime, to needing daily medication to start preventative measures.
Atonic Seizures are also referred to as drop seizures, these affect the body extremely different than the other types as to where most types will cause muscles to stiffen and lock up, atonic seizures will cause the muscles to go limp. These will follow the focal and generalized categories as well focal meaning that they are only affecting part of the brain though this is rare and most atonic seizures are generalized affecting both sides of the brain, and is not aware during the fit. These generally only last about 20 seconds, but can happen in clusters. If the person is standing, they will most likely fall to the ground, seek medical attention for any injuries following a fall such as hitting their head or breaking a bone. Depending on how frequent a person is suffering from these drop attacks they may need to take special measures such as wearing a helmet to not further any brain damage. If the person is sitting you will notice their body slump over, eyelids may droop. Majority of the time the person will be able to return to their usual activity shortly after, but in some cases they may need some time to collect themselves and rest before returning to their regular activity. When a person is suffering from a cluster of these atonic seizures, it means that they will be having these fits one after another. It is always important to get the individual to a place where they are not going to further any injury to themselves, from falling or hitting something. This is extremely important in the clusters because the last thing that you would want is for them to fall multiple times in a row.
After fully understanding the types of seizures you are dealing with it is much easier to understand how to treat and prevent future fits. When dealing with a high risk seizure disorder such as dravet syndrome the preventative measures are going to be extremely important. It does take time to find the proper balance with what you need, and slowly activating the endocannabinoid system to react in your favor. And then of course understanding how the cannabis will affect the person mentally, and their motor skills. Giving them enough time to get used to using the cannabis, just as with any medication it takes time to adjust to the effects.
The best way to decide how often you are going to be dosing is going to be trial and error while being accompanied by someone that fully understands what you are trying to achieve and knows what to look for in your symptoms. Keeping track of what products you are using and how you are using them is going to be important too. As much as we wish that there were doctors that would be open to doing these treatment plans for patients in a monitored environment to better understand all the effects of the cannabis and to be able to properly dose some one based off their specific needs, many doctors are very touchy on the cannabis subject.
My goal is to get as much information to patients that are open to using cannabis, and offer as much assistance as I possibly can to help achieve each individual's goal of lowering the frequency of their seizures or if possible to eliminate their seizures entirely.
I always promote preventative measures, as staying one step ahead of the seizures is ideal. There are many factors to take into account when thinking about starting to make the transfer to naturopathic medicine. I encourage logging everything, get a notebook and write down everything. What medications are being taken, how many milligrams, at what time, and most importantly a personal goal. What do you want to achieve medically? What are you looking for cannabis to do for you? Are you weaning yourself off of pharmaceuticals, if so which one do you want start with? It is important to know your goal at all times so you are working towards it. When picking the proper oil to use a few things that are going to be factors are, age, motor skills, and the severity of the seizures.
For example a younger child that has a mild seizure disorder such as absence seizures, your best option would be a hemp oil that contains no trace THC, based off of the frequency would judge how to dose. Maybe there are certain activities that you find that trigger the seizures such as high stress, lack of sleep, the after affects of alcohol, photosensitivity, or certain types of music. If you are aware of these triggers, use your CBD oil beforehand to be preventative, with absence seizures since they are mostly in children, a situation that you know may trigger the child’s absence seizure like going to see a movie in theater, the bright lights or the loud noise can cause a fit so use the CBD oil beforehand to avoid this. Stressful situations some children struggle with as well if they are going to attend something that can stress them out like a busy super market take a dose of CBD oil beforehand doing our best to take these preventive measures will infrequent the seizures, and hopefully go longer periods of time without suffering from a fit. When dealing with some of the more extreme types of seizures where there are convulsions involved, start with an all CBD oil. It may not be everything that the patient needs, as CBD oil that contains no THC is going to be derived from an industrial hemp material. There is also cannabis strains that are going to contain a higher level of CBD but still contains a small amount of THC this is going to be a high CBD oil that is derived from cannabis. High CBD oil derived from cannabis is going to be the best option simply because CBD and THC compliment each other the CBD will cancel out the psychoactive effects of the THC. You will also be absorbing a full spectrum of cannabinoids, they are all in the same plant for a reason they work together.
One of the most inspirational studies done on seizures using cannabis was a study done by Doctor Orrin Devinsky who is the director of the New York University Comprehensive Epilepsy Center, he conducted a study on Dravet Syndrome. Dravet Syndrome is going to be a genetic mutation of the SCN1A gene, this causes a lifelong form of epilepsy that consists of severe myoclonic seizures. This condition has a 15-20% mortality rate due to seizure related injuries such as drowning, infections, and prolonged seizures; this is called Sudden Unexpected Death in Epilepsy or SUDEP. When Doctor Devinsky conducted this study he took 120 patients total 60 of the patients took a cannabinol compound the other 60 did the placebo treatment. Among the CBD treated group the frequency of the seizures dropped by 39%, three of the patients seizures had subsided entirely. The placebo group saw a 13% reduction in the frequency of seizures, with none of the children being completely seizure free during the study. The 5% of children that were seizure free during the trial were suffering from 12 or more seizures a week before the trial took place. Doctor Devinsky also wrote that these children were entirely transformed they went from being wheelchair ridden, showing little to no emotion, and hardly able to open their eyes, to laughing, smiling, walking, they became entirely different children. Though some children dropped out of the study due to the medication change and suffered from major withdrawals, and of course the fact that some people are uncomfortable with the use of cannabis. The compound that was used in this study contained no THC or tetrahydrocannabinol which is the psychoactive cannabinoid found in cannabis. Only CBD or cannabidiol was used for this study, I believe that if there was a small amount of THC administered to those that showed more withdrawal symptoms I believes that they wouldn’t have dropped out of the study as it would have eased the symptoms with the vomiting and eased the aches and pains of trying to break a fever.
There is always going to be a struggle when moving away from one medication on to the next, and a withdrawal period should be expected as your body has become chemically dependent. The patients that were in the CBD study were administered 20 mg of CBD a day, I believe that if the patients were administered their medication on a basis that caters to their individual needs there would have been a higher success rate. Some may need more then 20 mg a day or 20 mg multiple times a day depending on how their body is reacting to the medication. As I mentioned before even administering a small amount of THC alongside the CBD I think would have been another study to follow along as well, but never using more THC than CBD, as the CBD cancels out the psychoactive effects of the THC. Using different ratios to cater to the patient's exact needs I believe is the key. Along with ensuring that the patient is eating properly your diet has a lot to do with how your body reacts to things, you need to fuel your body and brain with nourishment to flourish. Some may require a diet that is higher in fat, we feed our brains with fat, as I have mentioned before everyone is different so each body has different needs.
I strongly urge trying your hardest to stick with a good system and slowly wean off medications try not to cut pharmaceuticals cold turkey, as your body will not react well, it will trigger an extreme withdrawal. Dealing with withdrawals can be a trigger within itself, due to the stress and extreme chemical reaction in the brain. Cannabis does have many uses so when struggling with withdrawals you can use a CBD or to calm vomiting and pain, along with taking it every 4-8 hours, depending on what works best for you. Each person is different and metabolizes differently, has a different sized body, and processes differently, that is why it is important to journal your progress, reflect on what works and what did not work time everything out so that you can see how often you need to be dosing yourself along with how much so that you can compare days. Days that you realize that you did very good, you felt good, you were clear headed, stress free, and most importantly fewer seizures, or even seizure free. Those are going to be the days that you want to pay close attention to a few different things, there are so many different things that can affect your brain on a day to day basis, such as;
• Depending on what works for you, between 4-8 hours apart at a time.
How often you are taking a CBD oil, what is your dose?
• How many milligrams are you taking at a time
• Are you using a sublingual oil or are you taking a capsule form?
• Are you using something that has been bonded to a fat? Sugar? Is it a CBD distillate, isolate?
What medications are you taking?
• Are you weaning off medications?
• Which medications were lower each day?
• Have you fully gone off of any medications?
What did your diet consist of that day?
• Did you intake more fats than usual? It has been linked high fat diets feed your brain (good fats of course, like coconut oil and avocado)
• What was your caffeine intake?
• Did you take any vitamins?
• Drink any herbal teas?
What affected you?
• How do you feel? Are you happy, stressed, calm, sick, …?
• Is there any third party aspects that are making an impact? (Such as a meeting, social event, …)
• How many seizures did you suffer from?
• Was it less or more then usual?
• What were the length of each seizure that you had that day?
• How was the recovery? Shorter than normal longer than normal?
Answering these questions every day and logging it is going to make you understand your ailment more and help you achieve the goals that you have set for yourself. Slowly but surely you will gain control through understanding your body, to eventually take preventative measures and control your seizures as much as possible. This is also going to help your doctor understand what is best for you. Make sure that you are logging what cannabis products that you are using, are you using an all CBD oil during the day and using a 1:1/CBD:THC ratio at night. If you are using a sublingual, how long are you leaving it under your tongue before swallowing the rest?
I understand that this is a hard choice to make to change over to using a natural remedy rather than what you are used to using and what doctors are telling you to do. I had my struggles moving from pharmaceuticals myself, but it ended up being the best decision I ever made. The impact that it made was life saving, the pharmaceuticals made me gain weight, in addition to being extremely harsh on my liver and kidneys. I was able to have a clear head, my thinking got sharper, and best of all I was extremely happy after changing to cannabis. I suffered from PNES (Psychogenic NonEpileptic Seizures), they were linked to my mental health. I say this past tense because I started a cannabis regiment in 2013, along with educating myself and using myself as a test dummy I was able to understand different types of products after just over a year I was completely weaned off all pharmaceuticals and had a perfect regiment that I followed every single day. I learned myself, my brain, and my body, I was able to become completely self aware. I have been seizure free since late 2014, I live an active lifestyle, along with the consciousness of everything that I put in my body including the foods that I eat. I fuel my brain and body with only the things that they need including incorporating raw cannabis in to my diet, I use a hemp protein, I will also use raw/inactivated cannabis in my smoothies. Cannabis must be decarboxylated in order for it to be intoxicating or psychoactive, in the inactive form you can absorb the cannabinoids such as THCVA, THCA, CBDA, and CBGA which during activation turn to THC, THCV, CBD, or CBG. Though only THC, THCV, and in high doses CBN are psychoactive.
There are somethings that you can get here at Health for Life, we carry an array of CBD products. Tinctures are most popular because they are effective very quickly, they absorb through the blood vessels in your mouth, mainly through the two that are under your tongue. There are two basic types of tinctures, one derived from industrial hemp containing no THC, and the other is derived from cannabis usually from a high CBD plant, but does contain THC the ratios of CBD:THC can vary as there are so many different strains. We carry a few different brands, CBD for Life makes a oral spray that is made from industrial hemp and contains peppermint oil as well. This spray contains 10mg of CBD in each spray, so it is very easy to dose yourself with this. Peppermint is used a lot in tinctures because it is known to help with nausea and does help mask the herbs flavor. We also carry Vital this brand makes a few different tinctures, but their CBD tincture is made from industrial hemp and is full spectrum, with this they do not have as accurate of dosing as the spray and it is going to be a much thicker formula. It is sweetened, and has either a mint flavor to it or cinnamon. Vital also makes a THC tincture, that is made with cannabis but is not going to be high in CBD as its main focus would be THC.
Therefore this THC tincture is going to be made with Cannabis, they do not make them a specific strain as they have nothing on their packaging regarding so. I am sure that they do a mixed hybrid making for a fairly even tincture nothing that is going to make you too sleepy, but calming at the same time. My favorite tincture that is available here in Arizona is made by a company named Green Halo, it is called High CBD Tincture. They make these tinctures with strain specific cannabis strain generally a more indica dominant CBD strain holding a THC:CBD ratio between 1:1-1:2, these tinctures are going to be full spectrum as well.
One of the awesome things about the cannabis industry is that there is always new things hitting the market, this means that there will end up being a product that works best for one person and possibly different for the next, there is something for everyone it's just figuring out what is best for you Mary’s Medicinals makes patches that are going to be excellent for a multitude of things as they make them to where they are strain specific, they also create some that are going to have a high content of specific cannabinoids such as; CBD, a CBD:THC/1:1, CBN, THC-Indica, THC-Sativa, and THCA. I like that they make so many different options as these patches can be used for so many different illnesses with having little to no psychoactive effects is amazing. With these patches we have found the best place to put them is going to be on the top of the foot, where you have all of the blood vessels close to the surface of your skin, these patches provide a long lasting consistent dose straight to the blood stream. Some may find that these patches can give them the long lasting effects, without taking anything orally. They typically last 8-12 hours, but do take longer to kick in then taking something orally that is absorbed sublingually.
Some patients may use an inhalant such as a vapor pen, using an inhalant is going to have the fastest reaction time, but is not always possible for some patients due to the convulsions. If the patient can feel when the seizures are coming on then this may be the most effective option because it is extremely fast acting. This method is not always the best unless you are able to feel your seizures coming on, in addition to the convulsions making it difficult to achieve due to the muscle jerking or movements. There is always the option of using these vapors as a preventative measure, but they will wear off the quickest of all the methods. Some people may need to use the inhalant every 3 hours, as to where some may only need to use it every 6 hours, everyone is different and their body metabolizes things at a different rate. There are a few companies that make 1:1 CBD:THC cartridges, Timeless has a few strains that they make such as AC/DC and XJ-13 they are both going to be amazing cartridges that have a smooth inhale and a good flavor, making it easy for consumption. They also have a discrete smell and are very easy to keep on your person due to their convenience. MPX makes some good CBD:THC cartridges as well, they use a THC distillate, with a CBD distillate, and add terpenes, much like timeless, these are the ones that I have found to be effective and both Health for Life locations carry these cartridges. I do know that there are many other options out there it is all going to be based on where you are located along with where you go to look for your medication.
There is also the option of consuming the cannabis by eating an edible, I have found it fairly difficult to find edibles that are strain specific that are high in CBD, many companies more focus on THC. Vital does make a small hard candy that is all CBD these are great for on the go and do offer an amazing sublingual absorption. With edible options unfortunately it is normally easiest to achieve what you are looking to get by creating your own.
When creating anything of your own this chart will help you immensely as you need to reach certain degrees to activate what you are trying to pull from the cannabis. When going through the decarboxylation I recommend using a temperature that will be the least impactive towards the cannabis. Generally go with around 325 degrees when working with the plant matter this temperature falls between the activation of THC and CBD so you will be getting the benefits of both of them. When working with a concentrate such as a distillate or isolate, most of the time these are already going to be activated and ready for consumption. The product that I absolutely love working with when making edibles is going to be the butane or BHO extracted solids. These can be found strain specific, which is good for many reasons, it can be difficult to find a high CBD extraction but that is what having a CBD isolate or distillate is going to be good because you can customize what you are trying to achieve by adding more CBD to your mixture if your THC content is too high.
Written by Cami Crane
Patient Consultant - Health For Life North Mesa