PMC6306515_01
Time course of seizure burden and treatment exposure.. After three months of SRSE and numerous treatment failures, CBD treatment (blue) accompanied prompt resolution of seizures. On day 258, non-epileptic seizures emerged and were mistaken for epileptic seizures, prompting a course of prednisone (now discontinued) and zonisamide (now tapering off). Abbreviations: IVIG, intravenous immunoglobulin; SRSE, super-refractory status epilepticus.
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After numerous treatment failures (see Fig. 1), seizures were nearly controlled with intravenous midazolam (MDZ) or pentobarbital (PTB), though multiple attempts to wean either agent led to resurgence of seizures.
Clobazam and N-desmethylclobazam (NDCLB) levels as a function of cannabidiol exposure.. A dramatic non-linear rise in dose-normalized CLB and NDCLB levels accompanied CBD exposure. Maximum CBD dosage was achieved on day 10 and further elevations in serum CLB/NDCLB levels accompanied discontinuation of MDZ, PB, PER, and dose-reduction of LAC.
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Of note, compared to pre-CBD baseline, serum levels of CLB and N-desmethylclobazam (NDCLB) rose substantially (Fig. 2) during both titration and maintenance of CBD treatment, and despite aforementioned reductions in the weight-based dosage of CBD and CLB.