Marijuana and Epilepsy

by Tim and Pattie Shellman

Epilepsy is a condition in which certain brain cells become abnormally excitable and spontaneously discharge in an uncontrolled way, causing a seizure. In grand mal or generalized epilepsy, the abnormal cells are on both sides of the brain and the discharge produces convulsions (violent muscle spasms). In absence seizures, the generalized brain discharge causes a lapse of consciousness, but not convulsions. Partial seizures result from abnormal discharge in an isolated area of the brain and may occur with or without a change in consciousness.

Partial seizures with a change in consciousness, known as complex partial seizures, are caused by damage to the temporal or frontal lobes of the cerebral cortex. They were formerly known as psychomotor seizures because the symptoms also include motor activity (grimacing and repetitive mouth or hand movements are especially common). When overexcitation is confined to a very small area, the patient with epilepsy may have a strange sensation of déja vu, vertigo, fear, or an odd smell without a source. This experience, known as an aura, may or may not be followed by a full complex partial seizure. Epilepsy is treated mainly with anticonvulsant drugs, including carbamazepine (Tegretol), phenytoin (Dilantin), valproic acid (Depakote), phenobarbital, primidone (Mysoline), ethosuximide (Zarontin), and clonazepam (Klonopin). About 70% of patients get relief from one of these drugs, and another 10% are helped by some combination of them. Focal seizures and temporal lobe epilepsy, however, often respond poorly to these drugs. Furthermore, anticonvulsants have many potentially serious side effects, including bone softening, anemia, swelling of the gums, double vision, hair loss, headaches, nausea, decreased libido, impotence, depression, and psychosis. Overdoses or idiosyncratic reactions may lead to loss of motor coordination, coma, and even death.

Although the anticonvulsant properties of cannabis have been known since ancient times and were explored in the nineteenth century, this therapeutic use of the drug has been largely ignored in the past hundred years. Although the medical establishment is still showing little interest, more and more epilepsy sufferers are discovering the usefulness of cannabis. Tim Shellman has suffered from grand mal epilepsy since he was 15 years of age. He and his wife Pattie describe his use of cannabis in the treatment of his convulsive disorder.

My name is Tim Shellman and I am 29 years old. My wife and I have two children. I am currently disabled due to epilepsy. I quit school after the eighth grade so I could go to work. I began using marijuana recreationally soon thereafter.

My seizure condition started when I was 15 years old. I went to the University of Texas Medical Center in Galveston for possible diagnosis and treatment. I was told that I had pseudo seizures and they referred me to a psychiatrist. I continued to have seizures of an undiagnosed origin until I went to the Parkland Epilepsy Treatment Center in Dallas. They removed me from my medication and monitored me by 24-hour continuous EEG and closed circuit video camera. They recorded and witnessed my seizure episodes. My final diagnosis was secondarily generalized tonic/clonic seizures with left hemisphere onset.

I have been tried unsuccessfully on most all anticonvulsant drugs. During the time that I used marijuana recreationally I noticed a dramatic decrease in my seizure activity. When I was 17 years old my jaw was broken during a fight. My mouth was wired shut for six weeks. Because of this I could not take my seizure medicine. However I was able to smoke marijuana. My seizures were completely controlled during this time. When my wires were removed I did not resume my medication because the use of marijuana was so successful. I remained seizure-free for 8 months. At this point my supply of marijuana was cut off. After 2 weeks of no marijuana and no medication, I woke up one morning in a puddle of blood on the bathroom floor. My seizures had returned and I had struck my head against the bathtub. I started taking my medicine again at this point because marijuana was not available.

Presently I use marijuana in addition to my medication which is Phenobarbital, 180 mg 3 times a day. This high dosage of barbiturates along with the multitude of medicines in the past have damaged me physically and mentally. I have been tried on Dilantin, Tegretol, Depakote, Felbatol, Lamictal, and Neurontin, all of which were unsuccessful in any combination. The only relief I get for my seizures is from smoking marijuana. I have not relied solely on marijuana because it has become difficult to obtain.

Compared to Phenobarbital, the cost of marijuana is somewhat higher. But the price my body has to pay from the barbiturates is far greater. When marijuana is available to me, I smoke about 6 joints a day. I sometimes smoke from a pipe, which allows me to use less with an equal effect. The anticonvulsant properties of marijuana are not all that benefit me. I suffer from severe headaches and nausea and vomiting after a bad seizure. If I can smoke a joint during this time I get relief from these after effects. Marijuana is no longer a recreational drug for me. It has become my lifeline to normal seizure-free living.

My name is Pattie Shellman and I am writing on behalf of my husband Tim. He is 29 years old and has suffered from epilepsy since he was 15 years old. He has taken almost every anticonvulsant on the market, most of which were unsuccessful in controlling his seizures. He is presently taking 180 mg of Phenobarbital 3 times daily. Even with this huge amount of barbiturates his seizures remain uncontrolled. Because of the large amounts of medication that Tim has taken over the years, his body and mind are not what they used to be. His memory, both long and short term, has diminished rapidly. Sometimes his thought process seems delayed, making simple tasks difficult for him at times. The Phenobarbital has placed a strain on our marriage because it has suppressed his sexual appetite and capability. Tim takes the barbiturates as they are ordered and he does not abuse them; however, he has become physically addicted to them.

There is one thing that helps Tim more than any medication or combination of medications. That is the smoking of marijuana. When smoked in addition to the use of his barbiturates, his seizures are completely controlled. The marijuana also allows him to take a smaller dosage of Phenobarbital. Tim’s medical use of marijuana is a problem because we live in Texas where it is illegal for all purposes. Because he has to obtain marijuana illegally, it is not always available to him. There are very stiff penalties and fines for possession of marijuana here.

Not only does the marijuana help control his seizures, but it also helps to boost his appetite which has suffered in the past. Also when Tim does have a seizure, an awful headache lasting for hours or sometimes days usually follows. In this instance, if I can get a joint of marijuana for him, the pain in his head is usually resolved.

With marijuana being illegal, Tim is greatly concerned about the consequences he could suffer for using it. Therefore, his seizures and side effects remain uncontrolled.

I am hoping that your publication of Tim’s history and medical use of marijuana will aid the reversal of the present marijuana laws. The medical establishment needs to be enlightened about the positive effects of marijuana and its many medical properties.

Thank you for the opportunity to share this information. Tim and I are hoping that it will help in your advocacy of the medical use of marijuana.

P.S. This is the clarification you requested concerning Tim’s medications. He has used all the following unsuccessfully:

Dilantin 400 mg/day

Dilantin 200 mg/day with Tegretol 200 mg/day

Tegretol 1600 mg/day

Depakote 1250 mg/day

Phenobarbital 200 mg/day with Tegretol 200 mg/day

Phenobarbital 200 mg/day with Felbatol 600 mg/day

Felbatol 1200 mg/day

Neurontin 400 mg/day

Neurontin 200 mg/day with Phenobarbital 200 mg/day

Phenobarbital 540 mg/day

The above is Tim’s medication history. Like I said, all of these drugs and combinations of drugs have been unsuccessful in controlling his seizures. Tim has used marijuana in conjunction with most of these medications, but he does not always have marijuana available to him. He has used marijuana mostly with his current medication of Phenobarbital 540 mg daily. Since our last letter to you Tim obtained 4 oz of marijuana. Three days prior to receiving the marijuana he stopped taking his Phenobarbital. Tim smoked the marijuana solely for one month and did not have a single epileptic episode. One week after the marijuana ran out, Tim began having seizures again, even though he had resumed his Phenobarbital two days before running out of marijuana.

This is proof enough for us that marijuana used medicinally does work!! Thank you for your concern and advocacy of patients’ rights and for allowing us to share our situation with you and your readers.

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