大麻油成功治疗神经性脑蜡质脂褐沉症患者的超难治性癫痫持续状态

Athena Michaelides, Spyridon Bekas, A. Papaioannou, A. Lazaridou, P. Nicolaides
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摘要

在这里,我们描述了一个25岁的男性诊断为“变异型婴儿期晚发性”神经元样脂褐质病(NCL)的病例,他在15号染色体上的CLN6基因中有一个新的突变。患者在10岁时出现癫痫发作,并伴有共济失调、痉挛、认知能力下降和视力困难等进行性症状。在25岁的时候,癫痫发作对药物产生了抗药性,病人被麻醉昏迷,直到使用大麻油和美国食品和药物管理局(FDA)批准的抗癫痫药物被证明是挽救生命的。NCL的治疗目前包括癫痫发作的症状缓解,以及对行为、语言和视觉困难相关症状的支持性治疗。尽管有限,最近关于大麻素治疗难治性癫痫疗效的数据已经发表。由于大麻油目前尚未被FDA批准用于大多数配方,因此其在耐药性癫痫中的使用是轶事,并且仍然存在高度争议。中华神经科学杂志,2020;10(6):245-247 doi: https://doi.org/10.14740/jnr626
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Successful Treatment of Super-Refractory Status Epilepticus With Cannabis Oil in a Patient With Neuronal Ceroid Lipofuscinosis
Herein we describe a case of a 25-year-old man diagnosed with the “variant late infantile-onset” neuronal ceroid lipofuscinosis (NCL) who has a novel mutation in the CLN6 gene located on chromosome 15. The patient developed seizures at the age of 10 years along with progressive symptoms of ataxia, spasticity, cognitive decline and visual difficulties. At the age of 25 years, the seizures were drug-resistant, and the patient was put in an anesthesia-induced coma until the use of cannabis oil in combination with Food and Drug Administration (FDA)-approved anti-seizure drugs proved to be lifesaving. Treatment for NCL currently consists of symptomatic relief of seizures, and supportive therapies for associated symptoms of behavior, language and visual difficulties. Although limited, recent data on the efficacy of cannabinoids for treatment-resistant epilepsy have been published. Since cannabis oil is not currently FDA approved for most formulations, its use in drug-resistant epilepsy is anecdotal and remains highly controversial. J Neurol Res. 2020;10(6):245-247 doi: https://doi.org/10.14740/jnr626
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