A pediatric patient with Lennox-Gastaut syndrome developed cannabinoid hyperemesis syndrome from prescription cannabidiol, which resolved after CBD discontinuation without increased seizures.
Pediatric neurologists, epilepsy specialists, and gastroenterologists managing cannabinoid-related symptoms.
First CBD-caused CHSreported in the literature, in a pediatric epilepsy patient on prescription cannabidiol
What the researchers found
Monthly bouts of severe emesis unresponsive to anti-emetics began 6 months after starting the ketogenic diet while on CBD. CHS was suspected, CBD was discontinued, and emesis resolved within 2 months with no increase in seizure frequency.
Why it matters
This is the first reported case of CHS from pharmaceutical CBD used for epilepsy, expanding the understanding of which cannabinoids can cause CHS and raising awareness for epilepsy clinicians.
The numbers in context
Pediatric patient with Lennox-Gastaut syndrome. Monthly emesis episodes for ~6 months. Emesis resolved within 2 months of CBD discontinuation. No seizure increase or emesis hospitalizations for nearly 1 year post-discontinuation.
How the study worked
Case report with detailed clinical timeline, treatment history, diagnostic reasoning, and outcome following CBD cessation.
Who was studied
Single pediatric patient with Lennox-Gastaut syndrome on prescription cannabidiol and ketogenic diet.
What this study cannot tell us
Single case report. Cannot definitively prove CBD caused CHS vs. other factors. Ketogenic diet interaction possible. Timing coincidence cannot be excluded.
How to read the evidence
Single case report; lowest evidence level but notable as the first of its kind.
When this study was published
Recent case report expanding CHS etiology understanding.
The bigger picture
This case expands CHS beyond THC-associated use to include CBD, a compound generally considered safe. Clinicians prescribing CBD for epilepsy should be aware of this potential complication.
Replication
First case report; surveillance for additional cases needed.
Funding
Not specified in abstract
Conflicts of interest
Not specified in abstract
Questions still open
- Is CHS from CBD dose-dependent?
- Should patients on chronic CBD be monitored for CHS symptoms?
Read the original research
A Rare Case of Cannabinoid Hyperemesis Syndrome Secondary to Cannabidiol for Refractory Epilepsy.
JPGN reports, 4(1), e280
Citation
Katz, Daphna T; Fifi, Amanda; Milesi-Halle, Alessandra; Saps, Miguel. (2023). A Rare Case of Cannabinoid Hyperemesis Syndrome Secondary to Cannabidiol for Refractory Epilepsy.. JPGN reports, 4(1), e280. https://doi.org/10.1097/PG9.0000000000000280