Abstract

Background: An oromucosal spray formulation (Sativex^®) containing delta-9-tetrahydrocannabinol and cannabidiol is indicated to treat unresponsive severe spasticity in Multiple Sclerosis. A lot of clinical trials are underway demonstrating a potential role as supplemental therapy in various neurological conditions, in particular addressing pain and spasticity in adults and children.

Case Report: We present a 30-year-old man who was diagnosed with Vanishing White Matter disease at the age of 9. VWMS is a rare autosomal recessive syndrome characterized by progressive white matter deterioration, due to mutations in either one of the five subunits of eukaryotic translation initiation factor eIF2B. The classic phenotype includes ataxia, spasticity, cognitive decline and seizures from early childhood. As young adult, our patient showed severe spastic tetraparesis with spasms and neck muscle stiffness with right laterocollis. Clonazepam, baclofen and botulinum injections were tried with poor results. THC-CBD spray at the dose of 4 sprays per day improved muscular pain, spasms and night sleep, reduced modestly spasticity and caused only mild drowsiness. To maximize the spasticity treatment, a baclofen intrathecal infusion pump was positioned, but Sativex^® was continued after surgery for its positive effect on patient’s quality of life.

Conclusion: To our knowledge, this is the first time that THC-CBD has been in an adult patient with VWM. The treatment was well-tolerated, act moderately on spasticity but muscular spasm and night sleep improved as well as quality of life.

Keywords: Vanishing White Matter Disease; Leukoencephalopathy; Spasticity Treatment; THC-CBD Spray; Cannabinoids

References

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Citation

Citation: Giulia Galli., et al. “Cannabinoid Efficacy in Vanishing White Matter Disease: A Case Report”. Acta Scientific Neurology 4.10 (2021):.

Copyright

Copyright: © 2021 Giulia Galli., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.