CBD Helps Reduce Drug-Resistant Epileptic Spasms in Children | Research

The takeaway

Nearly 60% of children with drug-resistant epileptic spasms achieved at least 50% seizure reduction with adjunctive CBD treatment, with children with Down syndrome and cortical malformations showing the best responses.

Pediatric neurologists, parents of children with drug-resistant epilepsy, epilepsy researchers, and clinicians considering CBD for seizure management.

What the researchers found

Of 53 patients with drug-resistant childhood epileptic spasms treated with purified CBD (Epidyolex), 58.5% achieved ≥50% reduction in spasm frequency and 15% became completely spasm-free, with the highest response rates in patients with cortical malformations and Down syndrome.

Why it matters

Epileptic spasms persisting beyond age 2 are notoriously difficult to treat, and this study provides real-world evidence that CBD can meaningfully reduce spasm burden in this challenging population.

The numbers in context

n=53 patients; 58.5% achieved ≥50% spasm reduction; 15% spasm-free; 77.3% co-administered clobazam; adverse effects in 62.2%; 17% discontinued for lack of efficacy; 11.3% discontinued for adverse effects; drowsiness most common AE

How the study worked

Retrospective longitudinal study of 53 patients older than 2 years with drug-resistant epileptic spasms treated with purified CBD at Niño Jesus Hospital, Madrid (2020-2024), comparing spasm frequency before and after treatment.

What this study cannot tell us

Retrospective design; no control group; single center; clobazam co-administration in most patients makes it difficult to isolate CBD's independent effect; variable follow-up duration; relatively small sample.

How to read the evidence

Retrospective single-center study with no control group, but meaningful sample size and clear clinical outcomes for a difficult-to-treat condition.

When this study was published

Published 2026; covers treatments from 2020-2024.

The bigger picture

This adds to growing evidence supporting CBD as a viable option for treatment-resistant pediatric epilepsy, particularly in genetic conditions like Down syndrome where seizure management options are limited.

Questions still open

How much of the effect is due to CBD-clobazam synergy vs. CBD alone? Would earlier CBD introduction improve outcomes? What are the long-term effects of sustained CBD use in this population?

Common questions

Can CBD help children with epileptic spasms?

Yes — this study found that nearly 60% of children with drug-resistant epileptic spasms who received pharmaceutical-grade CBD (Epidyolex) had at least a 50% reduction in spasm frequency, with 15% becoming completely spasm-free.

Does CBD work better for certain types of epilepsy?

Children with Down syndrome and malformations of cortical development showed the highest response rates to CBD in this study, suggesting some underlying conditions may respond particularly well.

Read the original research

Cannabidiol as Adjunctive Treatment in Drug-Resistant Epilepsy With Epileptic Spasms Beyond Two Years of Age.

Pediatric neurology, 174, 81-85

View on PubMed ↗Publisher’s paper ↗

Citation

González-Alguacil, Elena; García Peñas, J Jose; Lamagrande Casanova, Nuria; Santana Cabrera, Elsa Maria; Duat Rodríguez, Anna; Soto Insuga, Víctor. (2026). Cannabidiol as Adjunctive Treatment in Drug-Resistant Epilepsy With Epileptic Spasms Beyond Two Years of Age.. Pediatric neurology, 174, 81-85. https://doi.org/10.1016/j.pediatrneurol.2025.10.013