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Study breakdown

68% of Infants With Treatment-Resistant Epileptic Spasms Responded to CBD Add-On Therapy

Retrospective CohortModerate evidence
The takeaway

In 28 infants with treatment-resistant infantile epileptic spasms syndrome, purified CBD achieved greater than 50% spasm reduction in 68% of patients, with 25% becoming spasm-free.

Pediatric neurologists, epileptologists, parents of children with IESS

68% response rate in treatment-resistant infantile spasms

What the researchers found

Of 28 infants with treatment-resistant IESS, 7 (25%) became spasm-free and 12 (43%) had >50% spasm reduction (total responder rate 67.8%). Response was notable in Down syndrome (5/7, 71%) and cerebral palsy (3/5, 60%). Median CBD dose was 25 mg/kg/day. Adverse effects were mild.

Why it matters

Infantile epileptic spasms are devastating and treatment-resistant cases have few options. A 68% response rate with good tolerability suggests CBD may fill an important gap, especially for infants with Down syndrome.

The numbers in context

28 infants; 67.8% responder rate; 25% spasm-free; 71% response in Down syndrome; median dose 25 mg/kg/day; baseline 69 spasms/day; mean follow-up 15 months.

How the study worked

Retrospective analysis of 28 infants with treatment-resistant IESS who received purified CBD (Epidyolex) as add-on therapy between July 2021 and June 2023. Mean follow-up 15 months.

What this study cannot tell us

Retrospective, uncontrolled design. Small sample (n = 28). No placebo comparison. Heterogeneous etiologies.

How to read the evidence

Retrospective case series without controls, though consistent with CBD efficacy in other epilepsy syndromes.

When this study was published

2024 publication with 2021-2023 data

The bigger picture

CBD is already approved for Dravet and Lennox-Gastaut syndromes and TSC. These results suggest its efficacy may extend to infantile epileptic spasms, particularly in genetic etiologies like Down syndrome.

Questions still open

  • Would a randomized controlled trial confirm these response rates in IESS?
  • What makes Down syndrome patients particularly responsive to CBD for epileptic spasms?

Common questions

Can CBD help with infantile spasms?
In this study of 28 infants with treatment-resistant spasms, purified CBD reduced spasms by more than 50% in 68% of patients, with 25% becoming spasm-free. Down syndrome patients responded particularly well (71%).
Is CBD safe for infants with epilepsy?
Adverse effects were mild in this study of infants as young as 6 months receiving CBD doses up to 50 mg/kg/day. EEG improvements tracked with clinical improvement.

Read the original research

Purified cannabidiol as add-on therapy in children with treatment-resistant infantile epileptic spasms syndrome.

Seizure, 115, 94-99

Citation

Reyes Valenzuela, Gabriela; Gallo, Adolfo; Calvo, Agustin; Chacón, Santiago; Fasulo, Lorena; Galicchio, Santiago; Adi, Javier; Fortini, Pablo Sebastian; Caraballo, Roberto. (2024). Purified cannabidiol as add-on therapy in children with treatment-resistant infantile epileptic spasms syndrome.. Seizure, 115, 94-99. https://doi.org/10.1016/j.seizure.2024.01.010

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