Medical marijuana
A certain chemical in marijuana has been used as an alternative treatment for epilepsy. (For Spectrum Health Beat)

Medical marijuana is a hot topic. You, your friends and your family probably have strong opinions about it.

If you have epilepsy and nothing is stopping your seizures, you might want one more opinion: Ask your doctor.

Epilepsy is a medical condition with seizures that include shaking, muscle stiffening or unconsciousness. About one in 26 Americans have it, yet it’s not a straightforward disease.

There are about 40 kinds of epilepsy ranging from occasional, almost unnoticeable seizures to those that make life difficult.

“The first step in treating epilepsy is getting an accurate diagnosis so your doctor can try different medications to reduce or eliminate seizures,” said David Burdette, MD, a clinical neurophysiologist at the Spectrum Health Medical Group Epilepsy Program. “Medication, or a cocktail of different medications, works for about two out of three people.”

That leaves about one in three patients that medications don’t help. If that’s you, it’s time to explore more aggressive options or alternative therapies.

One option is surgery. Before getting started, doctors will map your brain to find the area that is setting off the seizures. Surgeons then remove the problem area with precision.

Another approach is electrical stimulation, otherwise known as neurostimulation. This works almost like a pacemaker. Doctors connect wires to the base of your brain to either prevent seizures altogether or stop them before they get too bad.

Your doctor may also recommend changes to your diet or psychotherapy.

And, finally, your doctor may recommend a cannabinoid such as marijuana. It’s legal in Michigan and many other states if you get a medical marijuana ID Card signed by a doctor.

Not all marijuana has ‘the right stuff’

When you think of marijuana, you may think of getting high or experiencing euphoria. That’s because of tetrahydrocannabinol (also called THC), the psychoactive chemical in marijuana.

THC in marijuana doesn’t reduce seizures. In fact, you’ll want to avoid it as much as possible.

The compound in marijuana that may help with seizures is cannabidiol (or CBD). Unlike THC, it doesn’t create a feeling of euphoria. A well-known variety is called Charlotte’s Web, which is a liquid medical marijuana named for a little girl with Dravet Syndrome who had almost non-stop seizures until using CBD.

Getting relief isn’t as easy as it sounds. That’s because the marijuana you buy may not have a consistent, predictable level of CBD.

“Marijuana quality varies from plant to plant,” Dr. Burdette said. “The only way to test the CBD level is to send it to a lab in Colorado, but we can’t realistically do that with every plant.”

There’s hope on the horizon.

pharmaceutical company in the United Kingdom is doing clinical trials of CBD. If all goes well, epilepsy patients may be able to buy it from the pharmacist with a prescription in the future.

In the meantime, Dr. Burdette and his colleagues are taking an individual approach to the topic.

“If I have an epilepsy patient who is desperate and traditional medications have been unhelpful, I’ll support them getting a medical marijuana card,” he said. “It’s not the first treatment choice. But sometimes we need to look beyond traditional treatment to help our patients find relief.”