Six children in palliative care saw fewer seizures and less pain with medical cannabis | Research

The takeaway

In a case series of six pediatric palliative care patients in Italy, a titrated cannabis sativa extract reduced seizure frequency and pain intensity over one year, with only mild, transient side effects.

Pediatric palliative care providers, families of children with treatment-resistant epilepsy, medical cannabis researchers

All 6 patients showed reduced seizure frequency with no treatment discontinuations

What the researchers found

All six patients experienced a reduction in seizure frequency (with variable extent) after starting medical cannabis. Pain also improved based on caregiver evaluation, and analgesic medication use decreased. Side effects were mild and transient: drowsiness, euphoria, restlessness, and tachycardia. No treatment was discontinued and no overdoses occurred.

Why it matters

Children in palliative care often have treatment-resistant epilepsy and chronic pain with limited therapeutic options. This case series provides initial evidence that medical cannabis may be a tolerable and beneficial addition to their care.

The numbers in context

6 patients treated for 1 year; all had seizures during pre-treatment observation; all showed seizure frequency reduction; mild adverse events: drowsiness, euphoria, restlessness, tachycardia; 0 treatment discontinuations; 0 overdoses

How the study worked

Case series of six pediatric palliative care patients at an Italian center who received titrated plant extract of cannabis sativa for one year. Caregivers reported changes in seizure frequency, seizure intensity, and pain. Adverse events were monitored throughout.

What this study cannot tell us

Case series with only 6 patients and no control group. Outcomes were caregiver-reported without blinding. Variable extent of seizure reduction makes it hard to quantify the benefit precisely. No standardized pain assessment tools described.

How to read the evidence

Small case series without controls, providing preliminary evidence of tolerability and potential benefit.

When this study was published

Published in 2021.

The bigger picture

Pediatric palliative care represents a population where quality of life is the primary goal and standard treatments have often failed. The tolerability and apparent benefit seen here supports further investigation in this vulnerable group.

Questions still open

Would these results hold in a larger controlled trial? What specific cannabinoid ratios and doses provided the most benefit in these patients?

Common questions

What side effects did the children experience?

Side effects were mild and transient: drowsiness, euphoria, restlessness, and tachycardia. They resolved either spontaneously or with adjustments to the dosing schedule. No child had to stop treatment.

Did all children benefit?

All six patients showed some reduction in seizure frequency, though the extent varied. Caregivers also reported improvement in pain and reduced use of other analgesic medications.

Read the original research

The use of medical cannabis in pediatric palliative care: a case series.

Italian journal of pediatrics, 47(1), 229

View on PubMed ↗Publisher’s paper ↗

Citation

Divisic, Antuan; Avagnina, Irene; De Tommasi, Valentina; Santini, Anna; Brogelli, Laura; Giacomelli, Luca; Benini, Franca. (2021). The use of medical cannabis in pediatric palliative care: a case series.. Italian journal of pediatrics, 47(1), 229. https://doi.org/10.1186/s13052-021-01179-1