Division of Medical Toxicology, Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
J Med Toxicol. 2022 Jul;18(3):223-234. doi: 10.1007/s13181-022-00886-3. Epub 2022 Mar 29.
Cannabis' effect on seizure activity is an emerging topic that remains without consensus and merits further investigation. We therefore performed a scoping review to identify the available evidence and knowledge gaps within the existing literature on cannabis product exposures as a potential cause of seizures in humans.
A scoping review was conducted in accordance with the PRISMA Extension for Scoping Reviews guidelines. The PubMed and Scopus databases were searched over a 20-year period from the date of the database query (12/21/2020). Inclusion criteria were (1) English language original research articles, (2) inclusion of human subjects, and (3) either investigation of seizures as a part of recreational cannabinoid use OR of exogenous cannabinoids as a cause of seizures.
A total of 3104 unique articles were screened, of which 68 underwent full-text review, and 13 met inclusion/exclusion criteria. Ten of 11 studies evaluating acute cannabis exposures reported a higher seizure incidence than would be expected based on the prevalence of epilepsy in the general and pediatric populations (range 0.7-1.2% and 0.3-0.5% respectively). The remaining two studies demonstrated increased seizure frequency and/or seizure-related hospitalization in recreational cannabis users and those with cannabis use disorder.
This scoping review demonstrates that a body of literature describing seizures in the setting of cannabis exposure exists, but it has several limitations. Ten identified studies showed a higher than expected incidence of seizures in populations exposed to cannabis products. Based on the Bradford Hill criteria, delta-9 tetrahydrocannabinol (THC) may be the causative xenobiotic for this phenomenon.
大麻对癫痫发作活动的影响是一个新兴的话题，目前尚无共识，值得进一步研究。因此，我们进行了范围界定审查，以确定现有文献中关于大麻产品暴露作为人类癫痫发作潜在原因的可用证据和知识空白。
根据 PRISMA 扩展范围审查指南进行了范围界定审查。在 20 年的时间内，从数据库查询日期（2020 年 12 月 21 日）开始，在 PubMed 和 Scopus 数据库中进行了搜索。纳入标准为：（1）英语原创研究文章，（2）纳入人类受试者，以及（3）调查娱乐性大麻使用中的癫痫发作，或外源性大麻素作为癫痫发作的原因。
共筛选出 3104 篇独特的文章，其中 68 篇进行了全文审查，13 篇符合纳入/排除标准。在评估急性大麻暴露的 11 项研究中，有 10 项报告的癫痫发作发生率高于普通人群和儿科人群中癫痫的患病率（分别为 0.7-1.2%和 0.3-0.5%）。另外两项研究表明，娱乐性大麻使用者和大麻使用障碍者的癫痫发作频率增加和/或与癫痫发作相关的住院率增加。
这项范围界定审查表明，存在描述大麻暴露背景下癫痫发作的文献，但它存在几个局限性。已确定的 10 项研究表明，接触大麻产品的人群中癫痫发作的发生率高于预期。根据布拉德福德·希尔标准，Δ-9-四氢大麻酚（THC）可能是这种现象的致病因。
