The pros and cons of medical marijuana is a discussion focus at the fifth annual Queensland Epilepsy Symposium, Epilepsy — On the Horizon. Jointly hosted by Epilepsy Queensland Inc, Griffith University and St Vincent’s Private Hospital Brisbane, the event will be held at Gardens Point Campus of QUT University in George Street, Brisbane on Thursday, November 20, 2014.
Professor Roy Beran,a neurologist fromGriffith’s School of Medicinewill be one of the panellists discussing medical marijuana. He says he is dubious about the benefitsof the drug with regard to epilepsy.
“The point is that marijuana has been around for over 6000 years and if it was as good as people say it is, then there would be no need for trials because it would have proven its efficacy already,” he says. While pharmaceutical cannabis is available in Australia for treating pain and wasting associated with HIV and chemotherapy, and in the treatment of spasticity in multiple sclerosis, its efficacy in the treatment of severe refractory epilepsy or catastrophic epilepsy syndromes is unknown.
Trials underway
Trials are underway in the USA investigating the efficacy and safety of ‘medical marijuana’ in Dravet and Lennox-Gastaut syndromes, with results to date giving cautious optimism. Professor Terence O’Brien, the only Australian co-chair on the International League Against Epilepsy’s Taskforce on Pre-clinical Therapy Development,will discuss new and future treatments for people with epilepsy.
Aconcerted international research effort is underway to close a major ‘gap’ that has long existed in the treatment of epilepsy. “In the past 20 years, there has been an ‘explosion’ in new drugs to treat epilepsy, but 30 percent of people with epilepsy do not become seizure-free through medication or surgery,” says Professor O’Brien.
“New drugs and treatments have not been able to close this gap in the past 50 years — so we must address the reasons behind drug-resistant epilepsy and develop effective treatments. This group of people face increased injury and death rates; they cannot drive or work, and live with poor quality of life and the stigma associated with seizures.”
The taskforce is strongly focused on enticing government and industry to invest in research to develop drugs that can close this epilepsy treatment gap. Professor O’Brien will present promising pre-clinical data from animal trials of drugs and new types of therapies including genetic therapy, surgery and neurostimulation.
Meanwhile, Dr Chris DeGiorgio, Professor-in-Residence of Neurology at the University of California Los Angeles (UCLA) School of Medicin, will discuss the positive results of a randomized controlled trial to examine the safety and efficacy of Trigeminal Nerve Stimulation. TNS is a new investigational neuromodulation therapy for people with drug-resistant epilepsy.
Its potential as a treatment for epilepsy is of interest because it is non-invasive, can easily be applied by patients, is worn for 8 to 14 hours, and is less expensive than implantable neurostimulation devices. The trial, published by the American Academy of Neurology last year, was in preparation for a phase 111 clinical trial.
The trigeminal nerve is a cranial nerve just 1cm under the surface of the skin that conveys information from the face and connects directly to the brainstem. TNS allows for non-invasive electrical stimulation via a patch placed on the person’s forehead, modulating activity of the brain regions implicated in epilepsy, depression, ADHD and other disorders.
